Multiple Gastric Cancer after Successful Eradication of Helicobacter pylori Infection Mototsugu Kato 1 , Shouko Ono 1 , Masakazu Takahashi 2 , Keisuke Shinada 2 , Masahira Haneda 2 , Keiko Yamamoto 2 , Takeshi Yoshida 2 , Katsuhiro Mabe 2 , Yuichi Shimizu 2 , Masahiro Asaka 2 , Yasuaki Mori 3 , Manabu Nakagawa 4 , Souichi Nakagawa 4 1Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan 2Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan 3Mori Gastroenterological Clinic, Yoichi, Japan 4Nakagawa Ichouka Clinic, Sapporo, Japan Keyword: 除菌治療 , 胃癌予防 , 異時性多発癌 , 内視鏡治療 , 外科治療 pp.75-82
Published Date 2011/1/25
DOI https://doi.org/10.11477/mf.1403102108
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 Almost all gastric cancers develop from a background of H. pylori infection of the gastric mucosa. The treatment of gastric cancer is divided into endoscopic and surgical resection. The incidence of metachronous gastric cancer after removal of primary cancer is higher in endoscopic resection than in surgical resection. Since the development of endoscopic technique has expanded the indication for endoscopic treatment for early gastric cancer, multiple gastric cancers have become an important issue. Almost all residual cancers occur within 2years after endoscopic resection, but metachronous gastric cancers continue to occur for a long time after endoscopic treatment for primary cancer. Multi-center, randomized controlled trials in Japan reported that H. pylori eradication has significantly reduced the incidence of metachronous gastric cancers after endoscopic resection. Severe atrophy is a high risk factor for metachronous gastric cancer after successful eradication. Regarding remnant stomach cancers, the risk of these cancers is associated with not only H. pylori infection but also with intragastric circumstances after surgical resection such as reflux of duodenal juice and vagotomy.

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