H pylori eradication boosts survival outcomes for gastric cancer patients

In gastric cancer patients with Helicobacter pylori infection, eradicating the infection leads to improved survival rates, as shown in a study.

The retrospective cohort study included 1,293 patients (median age 59 years, 66.5 percent male) with gastric or esophagogastric junction adenocarcinoma who underwent curative gastrectomy with D2 lymphadenectomy and tested positive for H pylori infection.

Researchers analysed clinical outcomes, including overall survival (OS) and disease-free survival (DFS), using the Kaplan-Meier method, log-rank test, and Cox proportional hazards regression model. They also performed subgroup analysis based on crucial clinical information.

Of the patients, 125 received anti–H pylori treatment, which included triple therapy regimens consisting of amoxicillin, clarithromycin, and omeprazole for 14 days. The remaining 1,168 did not.

On survival analysis, the 5-year OS rate was higher in the treatment group than in the no treatment group (94.1 percent vs 73.8 percent). Anti-H pylori treatment was associated with a significant improvement in OS (hazard ratio [HR], 0.33, 95 percent CI, 0.18–0.60; p<0.001). This survival benefit persisted even after propensity score matching (HR, 0.50, 95 percent CI, 0.26–0.99; p=0.048).

Multivariable analysis confirmed the survival benefit with anti–H pylori treatment in terms of both OS (HR, 0.38, 95 percent CI, 0.17–0.87; p=0.02) and DFS (HR, 0.48, 95 percent CI, 0.28–0.83; p=0.008).

The OS advantage seen with anti–H pylori treatment was seen in the subgroup of patients with TNM stage II/III disease who received adjuvant chemotherapy (HR, 0.49, 95 percent CI, 0.24–0.99; p=0.046) but not among those who did not receive adjuvant chemotherapy (HR, 0.29, 95 percent CI, 0.04–2.08; p=0.22).

The present data highlight the importance of including H pylori screening and treatment in the surgical treatment of gastric cancer patients.