Treatment for Helicobacter pylori infection after surgery led to improved overall and disease-free survival among people with stomach cancer, according to study results published in JAMA Network Open.

H. pylori bacteria, which can cause gastric ulcers and inflammation of the stomach lining, is a strong risk factor for stomach cancer. Research has shown that H. pylori treatment lowers the risk of developing stomach cancer, and the new study suggests that it can also help people who already have the malignancy.

Runcong Nie, MD, PhD, of Sun Yat-sen University Cancer Center in Guangzhou, China, and colleagues carried out a retrospective study to understand whether treating H. pylori could improve stomach cancer survival. They analyzed data from people who were treated for gastric or gastroesophageal junction (where the stomach meets the esophagus) adenocarcinoma between 2010 and 2018 and followed through May 2021.

The study included 1,293 patients with confirmed H. pylori infection who were treated at a research center in Guangzhou. About two thirds were men, and the median age was 59 years. All participants underwent curative gastrectomy, or removal of the stomach.

The study population was divided into two groups based on whether they were treated for H. pylori infection around the time of their surgery or not. About 10% (125 patients) were treated. The treatment typically involved a combination of amoxicillin and clarithromycin (two antibiotics) plus omeprazole (a proton pump inhibitor that reduces stomach acid production) for 14 days.

At the three-year mark, the overall survival rate was 96% in the group that received H. pylori treatment, compared with 81% in the untreated group. At five years, the overall survival rates were 94% and 74%, respectively. A similar pattern was observed for disease-free survival, meaning patients were still alive without cancer recurrence (95% versus 70% at three years and 85% versus 59% at five years).

H. pylori treatment was linked to better outcomes after controlling for other variables, with a 62% improvement in overall survival and a 52% improvement in disease-free survival. Among people with Stage II/III cancer, H pyloritreatment was associated with survival benefits for those who received adjuvant (post-surgery) chemotherapy, but there was no significant difference for those who did not receive chemotherapy.

“The findings indicated that for patients with gastric cancer who have H. pylori infections, undergoing anti-H. pylori treatment may lead to improved survival outcomes,” wrote the researchers. “The study reinforces the importance of including H pylori screening and treatment in the surgical treatment of these patients.”

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