Removing bacteria reduces risk of stomach cancer relapse

August 1st, 2008 - 2:41 pm ICT by IANS  

London, Aug 1 (IANS) Removing a certain bacteria from the stomachs of post-operative gastric cancer patients can slash chances of such cancers redeveloping, according to a study. Almost all stomach cancers develop from H. pylori infected stomach lining that has been classified as a group I carcinogen by the WHO.

While H. pylori removal has a prophylactic effect on stomach cancer in animal models, trials in human beings have been controversial.

Mototsugu Kato and Masahiro Asaka of the Hokkaido University Graduate School of Medicine, Japan, and colleagues from the Japan Gast Study Group did a randomised controlled trial of 544 patients to investigate the possible prophylactic effect of H. pylori eradication on the development of metachronous stomach cancer after surgery to remove early gastric cancer.

Metachronous cancer develops after surgery to remove the initial cancer, but does not develop from that initial cancer. It develops at a new site in the stomach.

All patients were newly diagnosed and planning to have endoscopic treatment or in post-resection follow up after endoscopic treatment.

Patients with early stomach cancer were randomised to receive either an H. pylori eradication regimen (272 patients) or no treatment (272).

The eradication group received lansoprazole 30mg twice daily, amoxicillin 750mg twice daily, and clarithromycin 200mg twice daily for a week; the control group received standard care but no additional treatment to remove H. pylori.

Patients were then examined endoscopically at 6, 12, 24 and 36 months to see if a new cancer had developed at a different site in the stomach.

The researchers found that, at three-year follow-up, metachronous gastric cancer had developed in nine patients in the eradication group and 24 in the control group.

Overall, the risk of developing such cancer was reduced by around two-thirds in the eradication group compared with the control group. In the eradication group, 19 of patients had diarrhoea and 32 had soft stools.

These findings have been published in the Lancet.

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