scholarly journals Prognosis and clinicopathologic features in patients with gastric stump cancer after curative surgery

2020 ◽  
Vol 27 (3) ◽  
Author(s):  
C. Y. Kung ◽  
W. L. Fang ◽  
R. F. Wang ◽  
C. A. Liu ◽  
A. F. Y. Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peptic Ulcer ◽  
Lymph Node ◽  
Peptic Ulcer Disease ◽  
Gastric Surgery ◽  
Gastric Stump ◽  
Clinicopathologic Characteristics ◽  
Gastric Stump Cancer ◽  
Ulcer Disease ◽  
Primary Gastric Cancer

Background Gastric stump (“remnant”) cancer is the development of a malignancy related to previous gastric surgery. Prognosis in gastric stump cancer, compared with that in primary gastric cancer, is still controversial. Methods From January 1988 to December 2012 at a single medical centre in Taiwan, 105 patients with gastric stump cancer, including 85 with previous peptic ulcer disease and 20 with previous gastric cancer, were analyzed for clinicopathologic characteristics and overall survival (os). Results The 5-year os rates for patients with gastric stump cancer and with primary gastric cancer were 51.2% and 54.5% respectively (p = 0.035). Analysis of clinicopathologic characteristics indicated that, compared with patients having primary gastric cancer, those with gastric stump cancer had more lymph node metastasis (p < 0.001) and had been diagnosed at a more advanced stage (p = 0.047). Multivariate analysis with os as an endpoint showed that age [p = 0.015; hazard ratio (hr): 2.300; 95% confidence interval (ci): 1.173 to 4.509], tumour size (p = 0.037; hr: 1.700; 95% ci: 1.031 to 2.801), stromal reaction (p = 0.021; hr: 1.802; 95% ci: 1.094 to 2.969), and pathologic N category (p = 0.001; hr: 1.449; 95% ci: 1.161 to 1.807) were independent predictors in gastric stump cancer. The os rates for patients with gastric stump cancer who previously had gastric cancer or peptic ulcer disease were 72.9% and 50.0% respectively (p = 0.019). The Borrmann classification was more superficial (p = 0.005), lymph node metastases were fewer (p = 0.004), and staging was less advanced (p = 0.025) in patients with gastric stump cancer who previously had gastric cancer than in their counterparts who previously had peptic ulcer disease. Conclusions Survival is poorer in patients with gastric stump cancer who previously had peptic ulcer disease than in those who previously had primary gastric cancer. Patients with gastric stump cancer who previously had gastric cancer and could receive curative gastrectomy tended to have a better prognosis because of a more superficial Borrmann classification. Regular follow-up in patients who have undergone gastric surgery is recommended for the early detection of gastric stump cancer.  

Cost-Effectiveness of Screening With Polymerase Chain Reaction For Helicobacter Pylori To Prevent Gastric Cancer And Peptic Ulcers

2021 ◽  
Author(s):  
Aaron Oh ◽  
Han Truong ◽  
Judith Kim ◽  
Sheila D. Rustgi ◽  
Julian A. Abrams ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peptic Ulcer ◽  
Cost Effectiveness ◽  
Peptic Ulcer Disease ◽  
Cost Effective ◽  
Population Screening ◽  
Pcr Screening ◽  
Ulcer Disease ◽  
Polymerase Chain ◽  
H Pylori

Abstract Background: Helicobacter pylori is a major risk factor for gastric cancer. Screening and treatment of H. pylori may reduce the risk of gastric cancer and peptic ulcer disease. Polymerase chain reaction (PCR) of gastric biopsies provides superior sensitivity and specificity for the detection of H. pylori. This study explores whether population-based H. pylori screening with PCR is cost-effective in the US.Methods: A Markov cohort state-transition model was developed to compare three strategies: no screening with opportunistic eradication, 13C-UBT population screening and treating of H. pylori, and PCR population screening and treating of H. pylori. Estimates of risks and costs were obtained from published literature. Since the efficacy of H. pylori therapy in gastric cancer prevention is not certain, we broadly varied the benefit 30-100% in sensitivity analysis.Results: PCR screening was cost-effective and had an incremental-cost effectiveness ratio per quality adjusted life-year (QALY) of $38,591.89 when compared to 13C-UBT strategy with an ICER of $2373.43 per QALY. When compared to no screening, PCR population screening reduced cumulative gastric cancer incidence from 0.84% to 0.74% and reduced peptic ulcer disease risk from 14.8% to 6.0%. The cost-effectiveness of PCR screening was robust to most parameters in the model.Conclusion: Our modeling study finds PCR screening and treating of H. pylori to be cost-effective in the prevention of gastric cancer and peptic ulcer disease. However, the potential negative consequences of H. pylori eradication such as antibiotic resistance could change the balance of benefits of population screening.

Association ofHelicobacter pyloriand Epstein-Barr virus with gastric cancer and peptic ulcer disease

2008 ◽  
Vol 43 (6) ◽  
pp. 669-674 ◽  
Author(s):  
Ashish Saxena ◽  
Kashi Nath Prasad ◽  
Uday Chand Ghoshal ◽  
Narendra Krishnani ◽  
Monty Roshan Bhagat ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Epstein Barr Virus ◽  
Ulcer Disease ◽  
Barr Virus ◽  
Epstein Barr

The Effect of Eradicating Helicobacter Pylori on the Development of Gastric Cancer in Patients with Peptic Ulcer Disease

2005 ◽  
Vol 100 (5) ◽  
pp. 1037-1042 ◽  
Author(s):  
Susumu Take ◽  
Motowo Mizuno ◽  
Kuniharu Ishiki ◽  
Yasuhiro Nagahara ◽  
Tomowo Yoshida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Ulcer Disease ◽  
Development Of Gastric Cancer

scholarly journals The Human Gastric Pathogen Helicobacter pylori and Its Association with Gastric Cancer and Ulcer Disease

Ulcers ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-23 ◽  
Author(s):  
Bianca Bauer ◽  
Thomas F. Meyer
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Strain Differences ◽  
Protective Effects ◽  
Ulcer Disease ◽  
Prophylactic Measures ◽  
H Pylori

With the momentous discovery in the 1980's that a bacterium, Helicobacter pylori, can cause peptic ulcer disease and gastric cancer, antibiotic therapies and prophylactic measures have been successful, only in part, in reducing the global burden of these diseases. To date, ~700,000 deaths worldwide are still attributable annually to gastric cancer alone. Here, we review H. pylori's contribution to the epidemiology and histopathology of both gastric cancer and peptic ulcer disease. Furthermore, we examine the host-pathogen relationship and H. pylori biology in context of these diseases, focusing on strain differences, virulence factors (CagA and VacA), immune activation and the challenges posed by resistance to existing therapies. We consider also the important role of host-genetic variants, for example, in inflammatory response genes, in determining infection outcome and the role of H. pylori in other pathologies—some accepted, for example, MALT lymphoma, and others more controversial, for example, idiopathic thrombocytic purpura. More recently, intriguing suggestions that H. pylori has protective effects in GERD and autoimmune diseases, such as asthma, have gained momentum. Therefore, we consider the basis for these suggestions and discuss the potential impact for future therapeutic rationales.

scholarly journals Genome sequences of 65Helicobacter pyloristrains isolated from asymptomatic individuals and patients with gastric cancer, peptic ulcer disease, or gastritis

2013 ◽  
Vol 68 (2) ◽  
pp. 39-43 ◽  
Author(s):  
Thomas G. Blanchard ◽  
Steven J. Czinn ◽  
Pelayo Correa ◽  
Teruko Nakazawa ◽  
Monika Keelan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Genome Sequences ◽  
Ulcer Disease ◽  
Asymptomatic Individuals
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