Helicobacter pylori and gastric cancer: current status of the Austrian-Czech-German gastric cancer prevention trial (PRISMA-Study)

R73; AIM To test the hypothesis that Helicobacter pylori eradication alone can reduce the incidence of gastric cancer in a subgroup of individuals with an increased risk for this fatal disease.METHODS It is a prospective, randomized,double-blind, placebo-controlled multinational multicenter trial. M...

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Published in:	世界胃肠病学杂志(英文版) Vol. 7; no. 2; pp. 243 - 247
Main Authors:	S.Miehlke, C.Kirsch, B.Dragosics, M.Gschwantler, G.Oberhuber, D.Antos, P.Dite, J.Lauter, J.Labenz, A.Leodolter, P.Malfertheiner, A.Neubauer, G.Ehninger, M.Stolte, E Bayerdorffer
Format:	Journal Article
Language:	English
Published:	Medical Department I, Gastroenterology, Hematology, Oncology,Pulmonology & Infectious Diseases, Technical University Hospital Carl Gustav Cams, Dresden, Germany%Gesundheitszentrum Sud, Vienna, Austria %Medical Department 4, Krankenanstalt Rudolfstiftung, Vienna, Austria %Institute for Pathology, General Hospital, Vienna, Austria %Surgical Department, Ludwig-Maximilians-University Hospital Groβhadern, Munich, Germany %Univerzitni nemocnice Jihlavska, Brno-Bohunice, Czech Republic %Institute for Medical Statistics, Otto-von-Guericke-University,Magdeburg, Germany%Department of Medicine , Evang, Jung - Stilling Hospital, Siegen,Germany%Department of Gastroenterology, Otto - v. - Guericke University Hospital, Magdeburg, Germany%Department for Hematology, Oncology& Immunology, University Hospital Marburg, Germany%lnstitute of Pathology, Klinikum Bayreuth, Bayreuth, Germany 01-04-2001
Subjects:	gastritis/drug therapy Helicobacter pylori stomach neoplasms/drug therapy Helicobacter infections/drug therapy gastritis/microbiology stomach neoplasms /microbiology Helicobacter infections/complications
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Summary:	R73; AIM To test the hypothesis that Helicobacter pylori eradication alone can reduce the incidence of gastric cancer in a subgroup of individuals with an increased risk for this fatal disease.METHODS It is a prospective, randomized,double-blind, placebo-controlled multinational multicenter trial. Men between 55 and 65 years of age with a gastric cancer phenotype of Helicobacterpylori gastritis are randomized to receive a 7-day course of omeprazole 2 × 20 mg,clarithromycin 2 × 500 mg, and amoxicillin 2 ×lg for 7 days, or omeprazole2 × 20mg plusplacebo. Follow - up endoscopy is scheduled 3months after therapy, and thereafter in one-year intervals. Predefined study endpoints are gastric cancer, precancerous lesions (dysplasia, adenoma), other cancers, anddeath.RESULTS Since March 1998, 1524 target patients have been screened, 279 patients (18.3%) had a corpus-dominant type of H.pylori gastritis, and 167 of those were randomized (58.8%). In the active treatment group (n -- 86), H. pylori infection infection was cured in 88.9% of patients. Currently, thecumulative follow-up time is 3046 months (253.8patient-years, median follow-up 16 months). So far, none of the patients developed gastric cancer or any precancerous lesion. Three(1.8%) patients reached study endpoints other than gastric cancer.CONCLUSION Among men between 55 and 65years of age, the gastric cancer phenotype of H.pylori gastritis appears to be more common than expected. Further follow- up and continuing recruitment are necessary to fulfil the main aim of the study.
ISSN:	1007-9327
DOI:	10.3748/wjg.v7.i2.243