Researchers from Japan have reported that antibiotic treatment of patients with gastric cancer decreases the rate of metachronous recurrences. The details of this randomized trial were published in the August 2008 issue of Lancet Oncology.¹

The prevalence of gastric cancer has been steadily declining in the United States but is still the leading cause of cancer in Asia, accounting for 18% of cancer deaths in Japan. Worldwide gastric cancer is the second leading cause of cancer deaths. Several risk factors have been associated with an increased risk of developing gastric cancer. These include:

• Infection with the Helicobacter (H.) pylori bacteria
• Smoking
• High nitrate consumption
• Low dietary vitamin A and C
• Consumption of smoked foods
• Poor drinking water
• Lack of refrigeration

Many studies have indicated that eradication of the H. pylori infection may decrease the risk of developing gastric cancer. In western societies it is suspected that more than half the cases of noncardia gastric adenocarcinoma are attributable to smoking, gastric ulcers, elevated dietary nitrite intake, or H. pylori infection. In Asia H. pylori may be responsible for a higher fraction of gastric carcinoma cases. It has been proposed that eradication of H. pylori could reduce the incidence of gastric cancer; patients with this infection are routinely treated in the United States and Europe. Chinese researchers have reported that eradication of H. pylori infection decreases the risk of gastric cancer in most persons but not in persons who have precancerous lesions.

The current study looked at the effects of postsurgical antibiotic therapy designed to eradicate H. pylori infections in patients with resected gastric cancer. This study included 544 patients with early gastric cancer treated with endoscopy. Patients were randomly allocated to receive amoxicillin and clarithromycin for one week. With three years of follow up, there were nine metachronous gastric cancers in the antibiotic group and 24 in the control group. This represented a 70% reduction in the risk of a second primary gastric cancer with the use of antibiotics.

Comments: This study confirms the effectiveness of antibiotics in eradication H. pylori and decreasing the incidence of second primary tumors in patients treated for early gastric cancer.

Related News:

Eradication of Helicobacter pylori (H. pylori) May Not Affect Precancerous Gastric Lesions (01/22/2004)

Reference:

¹ Fukase K, Kato M, Kikuchi S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open label, randomized controlled trial. Lancet Oncology. 2008;372:392-397.