Dados do Resumo

Título

Influence of Helicobacter pylori infection on the survival of patients with gastric cancer in Brazil

Introdução

Infection with the bacteria Helicobacter pylori is associated with a risk of up to 63% for gastric cancer. Its impact on the survival of patients with this neoplasm has not been completely elucidated in Brazil. It is believed that the infection may be associated with a more favorable prognosis, especially for gastric cancer in the non-cardia region. The identification of subgroups with different prognoses allows us to improve the clinical approach, improving quality of life and survival probabilities.

Objetivo

The objective of this study was to estimate the overall survival probability of patients with gastric adenocarcinoma and H. pylori infection status.

Métodos

This is a hospital cohort study carried out in São Paulo (SP) and Goiânia (GO), from 2016 to 2024. Patients of both sexes, aged between 18 and 75 years and diagnosed with gastric adenocarcinoma (ICD, C16) were included in the study. Individuals without an available histopathological report or without physical and/or psychological conditions to participate were excluded. Outcomes were categorized as death from cancer, death from other causes or loss to follow-up when there was no information for more than two years. The estimated overall survival analyzed was 1, 3 and 5 years after diagnosis, using the Kaplan-Meier method. The log-rank test was applied to compare survival curves. The research was approved by the Research Ethics Committee of the Antônio Prudente Foundation, opinion number 3,174,666. All participants who agreed to participate in the study previously signed the Free and Informed Consent Form (TCLE).

Resultados

This cohort study included 234 patients with gastric adenocarcinoma, of whom 24.4% were diagnosed with H. pylori infection. Among those positive, the majority were male (57.9%), under 60 years old (68.4%) (p= 0.047), had more than 9 years of schooling (70.0%), and had a lesion in the non-cardia region (79.2%), poorly differentiated histological grade (53.6%) and diffuse Lauren type (52.8%). The 5-year overall survival was 51.3%. In positive patients, 5-year survival was higher (64.7%) compared to negative patients (47.2%) for H. pylori infection (p= 0.038). The average overall survival was 42.6 months (confidence interval 95% (CI95%) 39.7 – 45.5), being 48.4 months (CI95% 42.9 – 53.8) for H. pylori positive patients and 40, 8 months (CI95% 37.4 – 44.1) for H. pylori negative patients. Survival was similar between men (68.5%) and women (67.3%) with H. pylori. However, among H. pylori-negative patients, men (50.9%) had better survival than women (41.0%).

Conclusões

The greater survival rate in patients with gastric adenocarcinoma positive for H. pylori infection may indicate that the infection leads to a less aggressive form of the disease. H. pylori may also be associated with earlier diagnosis and an inflammatory response that limits cancer progression. On the other hand, H. pylori-negative patients may present with more advanced and aggressive forms of the disease, resulting in shorter survival.

Financiador do resumo

Fundação de Amparo à Pesquisa do Estado de São Paulo

Palavras Chave

Gastric; Neoplasms; oncobacteria