Patients who test negative for the bacterium Helicobacter pylori might have a worse prognosis after curative surgery for gastric cancer than those who are positive, according to researchers reporting in the March issue of The Lancet Oncology. "Tumour-specific immune responses might be downregulated in patients who are negative for H pylori and these patients should be followed up carefully because of a poor outlook", says lead author Dr Georgios Meimarakis (University of Munich, Germany).

Although H pylori has been associated with the development of gastric cancer, some patients are negative for H pylori. Gastric cancer is a disease with a poor outlook and therefore predictive factors are needed to identify early those who are at risk of relapse or death. Only a few studies have looked at whether H-pylori status is predictive of patient outlook. However, these studies were unable to answer this question definitively. Therefore, Meimarakis and colleagues assessed 166 patients who had had curative surgery for gastric adenocarcinoma between 1992 and 2002 and measured their survival in relation to their H pylori status.

After a median follow-up of 53 months, patients positive for H pylori had a relapse-free survival of 56.7 months and overall survival of 61.9 months compared with a relapse-free survival of 19.2 months and overall survival of 19.2 months for those who were H-pylori negative. Depth of tumour invasion, lymph-node metastasis, and older patient age were also prognostic factors for survival.

Dr Meimarakis states: "The identification of H-pylori status as an independent prognostic factor could be a useful tool in clinical practice to distinguish effectively between patients at high risk and low risk for adverse disease outcome. H-pylori status can be assessed easily in the clinic before resection. Thus, our study might contribute to a new classification of gastric cancer and have a substantial effect on disease outcome". If confimed, th
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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
27-Feb-2006

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