Summary
This retrospective cohort study of 491 Japanese patients with locally advanced gastric cancer found that H. pylori infection status significantly modified the efficacy of adjuvant S-1 chemotherapy. H. pylori-positive patients exhibited substantially better overall and disease-free survival compared to H. pylori-negative patients (OS HR 0.593; DFS HR 0.679), with propensity score matching indicating that S-1 chemotherapy was notably more effective in H. pylori-positive tumours. The authors propose that H. pylori modulates host immune responses in a manner that enhances chemotherapeutic efficacy, though the mechanistic basis remains to be elucidated.
UK applicability
H. pylori prevalence in the United Kingdom is substantially lower than in Japan, limiting the direct applicability of these findings to UK gastric cancer populations. However, the findings may inform stratified treatment approaches for the smaller proportion of UK patients with H. pylori-associated gastric cancer and warrant investigation in Western cohorts.
Key measures
Overall survival (OS) hazard ratio; disease-free survival (DFS) hazard ratio; H. pylori infection status (positive/negative); treatment group (surgery-only vs. adjuvant S-1 chemotherapy)
Outcomes reported
The study compared overall survival (OS) and disease-free survival (DFS) in advanced gastric cancer patients stratified by H. pylori infection status, across surgery-only and adjuvant S-1 chemotherapy treatment groups. H. pylori-positive patients demonstrated significantly improved survival outcomes compared to H. pylori-negative patients in both OS and DFS measures.
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