Clinical features of gastric cancer discovered after successful eradication of Helicobacter pylori: results from a 9-year prospective follow-up study in Japan


Dr T. Kamada, Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Matsushima 577, Kurashiki 701-0192, Japan.


Background : Eradication of Helicobacter pylori is expected to prevent the development of gastric cancer. However, gastric cancer is sometimes discovered after successful eradication of H. pylori.

Aim : To conduct a prospective study to determine the clinical features of patients who underwent successful eradication and were later diagnosed with gastric cancer.

Methods : A total of 1787 patients (1299 males and 488 females; mean age, 58.2 years; range: 15–84) who underwent successful eradication therapy between April 1994 and March 2001 were our study subjects.

Results : Gastric cancer occurred at a rate of 1.1% (20 of 1787) during the follow-up period. Gastric cancer comprises six of 105 (5.7%) with early gastric cancer after endoscopic resection, 12 of 575 (2.1%) with gastric ulcer and two of 453 (0.4%) with atrophic gastritis. Gastric cancer did not develop in any patient with duodenal ulcer. All patients with gastric cancer had baseline severe atrophic gastritis in the corpus.

Conclusion : Careful endoscopic examination is necessary even after successful eradication of H. pylori in patients with early gastric cancer or gastric ulcer with severe mucosal atrophy in the corpus.