Ji Yong Ahn

The effect of eradication of Helicobacter pylori on gastric cancer prevention in healthy asymptomatic populations

Although many epidemiologic studies have evaluated the effect of Helicobacter pylori eradication on gastric cancer, the effect is still uncertain in general populations. We evaluated whether H. pylori eradication would affect the incidence of gastric cancer in healthy asymptomatic populations.

The incidence and locational predilection of metachronous tumors after endoscopic resection of high-grade dysplasia and early gastric cancer.

BackgroundThe incidence of metachronous lesions after endoscopic resection (ER) of high-grade dysplasia (HGD) has not been evaluated, and optimal surveillance strategy remains vague. This study aimed to evaluate the incidence and characteristics of metachronous tumors including HGD and early gastric cancer (EGC) arising after ER.PatientsThe medical records of 2779 patients with 2981 lesions (445 patients with HGD and 2334 patients with EGC) who underwent ER and surveillance endoscopy at Asan Medical Center between April 1999 and December 2011 were retrospectively reviewed, and clinicopathological features of metachronous tumors were analyzed.ResultsNinety-six metachronous lesions (17 HGD and 79 EGC) occurred in 92 patients during median 42xa0months of follow-up period (range 26–58xa0months). The 5-year and 10-year overall cumulative incidences of metachronous tumors were 4.6 and 10.5xa0%, respectively, and were on steady rise up to 10xa0years. The 5- and 10-year cumulative incidences of metachronous lesions were 4.1 and 8.4xa0% in HGD group and 4.7 and 11.3xa0% in EGC group (Pxa0=xa00.578), respectively. The size of metachronous tumors was significantly smaller than initial lesion (2.3 vs. 1.9xa0cm, Pxa0=xa00.039). Lower third of the stomach was most frequent site for both initial and metachronous lesions (77.1 and 70.8xa0%, respectively) and age was the significant predicting factor for metachronous tumors.ConclusionsCumulative incidence of metachronous tumors after ER of HGD was comparable to the incidence after ER of EGC. Surveillance endoscopy can be considered at least for 10xa0years, with special attention on the lower third of the stomach.