Effect of helicobacter pylori eradication on prognosis after gastrectomy for gastric cancer: A systematic review and meta-analysis.

Abstract

e16104 Background: Gastric cancer is the fifth most common cancer and the fifth leading cause of cancer-related death worldwide. One of the primary risk factors for this cancer is infection with Helicobacter pylori (H. pylori), which highlights the importance of including H. pylori treatment in high-risk patients. However, the effectiveness of H. pylori eradication in post-gastrectomy patients remains controversial. In this study, we investigated the efficacy of H. pylori eradication in gastric cancer patients who underwent gastrectomy, with the aim of determining its impact on the prognosis of this population. Methods: A database search of published studies of PubMed, Cochrane, and Embase was conducted. We included observational studies that compared H. pylori eradication versus non-eradication in adult patients. Hazard ratio (HR) was used to assess overall survival (OS) and gastric cancer recurrence, with 95% confidence intervals (CIs). Heterogeneity was evaluated using I 2 statistics, and a p-value < 0,05 was considered statistically significant. Statistical analysis was performed using R software 4.4.1 version. Results: This meta-analysis included 5 studies comprising 3194 patients, 1095 in the H. pylori eradication group and 2099 in the non-eradication group. Males constituted the majority of the population with 2103, while females numbered 1091. Eradicating H. pylori significantly improved OS (HR: 2.4454; CI 95%: 1.5754 to 3.7956; p < 0.001; I 2 = 60%) compared to non-eradicated patients. Additionally, gastric cancer recurrence rates were lower in the eradication group (HR: 1.8418; CI 95%: 1.2791 to 2.6520; p = 0.001; I 2 = 15%). Conclusions: Our systematic review and meta-analysis demonstrated that H. pylori eradication is associated with superior prognosis in patients undergoing gastrectomy for gastric cancer. Eradication therapy was linked to prolonged OS and reduced gastric cancer recurrence. These findings underscore the importance of treating H. pylori in this population, although further RCTs are warranted to validate these results.