Abstract
Background: Recent studies have suggested a controversial role of Helicobacter pylori infection in gastric cancer prognosis. The aim of the present study was to investigate the potential impact of H. pylori status on the prognosis of patients with gastric cancer in a Chinese prospective cohort. Methods: Between 2007 and 2009, 261 patients with curatively resected gastric cancer were enrolled in the study. H. pylori status was defined by means of immunohistochemical staining in tumour and non-neoplastic tissues. Treatment prognosis was measured in terms of cancer-specific survival and disease-free survival (DFS). Univariate and multivariate Cox regression models were used to assess the association between H. pylori status and patient prognosis. Results: Positivity for H. pylori infection was observed in 188 of the 261 patients (72.0%). In patients positive for H. pylori, mean cancer-specific survival was 55.2 months [95% confidence interval (CI): 53.4 to 56.9 months] and mean DFS was 53.9 months (95% CI: 51.8 to 56.0 months); the same survivals were, respectively, 45.1 months (95% CI: 42.2 to 47.9 months) and 43.7 months (95% CI: 40.4 to 47.0 months) in patients negative for H. pylori. In univariate analysis, positive H. pylori status was associated with better cancer-specific survival [hazard ratio (HR): 0.486; 95% CI: 0.271 to 0.870; p = 0.015] and DFS (HR: 0.540; 95% CI: 0.307 to 0.950; p = 0.033). In multivariate analysis, H. pylori was an independent prognostic factor for cancer-specific survival (HR: 0.485; 95% CI: 0.265 to 0.889; p = 0.019). Conclusions: Our study demonstrates that positive H. pylori status is a beneficial prognostic indicator in patients with gastric cancer and might suggest possible therapeutic approaches for gastric cancer. Further research is required to better understand inflammation mechanisms and cancer progression.