Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.2760
Revised: November 9, 2013
Accepted: November 28, 2013
Published online: March 21, 2014
Processing time: 214 Days and 3.7 Hours
Helicobacter pylori (H. pylori) plays an important role in gastric carcinogenesis, as the majority of gastric cancers develop from H. pylori-infected gastric mucosa. The rate of early gastric cancer diagnosis has increased in Japan and Korea, where H. pylori infection and gastric cancer are highly prevalent. Early intestinal-type gastric cancer without concomitant lymph node metastasis is usually treated by endoscopic resection. Secondary metachronous gastric cancers often develop because atrophic mucosa left untreated after endoscopic treatment confers a high risk of gastric cancer. The efficacy of H. pylori eradication for the prevention of metachronous gastric cancer remains controversial. However, in patients who undergo endoscopic resection of early gastric cancer, H. pylori eradication is recommended to suppress or delay metachronous gastric cancer. Careful and regularly scheduled endoscopy should be performed to detect minute metachronous gastric cancer after endoscopic resection.
Core tip: In Japan and Korea, mucosal gastric cancer without concomitant lymph node metastasis is usually treated with endoscopic resection. However, gastric cancer recurrence following endoscopic resection is a significant problem. Secondary metachronous gastric cancers often develop due to atrophic mucosa left untreated after endoscopic treatment. Currently, all available evidence suggests that Helicobacter pylori (H. pylori) eradication represents a primary chemopreventive strategy. However, the efficacy of H. pylori eradication for the prevention of metachronous gastric cancer has been controversial. Therefore, endoscopists should inspect the entire stomach for minute or occult metachronous gastric cancer. In addition, regular surveillance endoscopy should be performed.