{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T22:34:40Z","timestamp":1776810880980,"version":"3.51.2"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":62,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\"><jats:italic>Helicobacter pylori<\/jats:italic><\/jats:styled-content> (<jats:italic>Hp<\/jats:italic>) infection is associated with metachronous gastric cancer (GC) after endoscopic submucosal dissection resection (ESD) in patients with early GC (EGC), but this association has not been well investigated in elderly patients. This study investigated whether <jats:italic>Hp<\/jats:italic> infection status was associated with metachronous GC after ESD in patients aged \u2265\u200975\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study involved 298 EGC patients aged \u2265\u200975\u2009years who underwent ESD. The <jats:italic>Hp<\/jats:italic>\u2010negative group (<jats:italic>n<\/jats:italic>\u2009=\u2009233) included patients with negative or eradicated <jats:italic>Hp<\/jats:italic> infection, whereas the <jats:italic>Hp<\/jats:italic>\u2010positive group (<jats:italic>n<\/jats:italic>\u2009=\u200965) included patients with persistently positive infection or failed eradication. The primary outcome was metachronous GC occurring at \u2265\u20091\u2009year after ESD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median patient age was 78\u2009years (interquartile range [IQR]: 76\u201380\u2009years). During a median follow\u2010up of 4.4\u2009years (IQR: 2.9\u20135.9\u2009years), metachronous GC occurred in 16 (6.9% [16\/233], 16.3 cases\/1000 person\u2010year) and 10 (15.4% [10\/65], 37.5 cases\/1000 person\u2010year) patients in the <jats:italic>Hp<\/jats:italic>\u2010negative and <jats:italic>Hp<\/jats:italic>\u2010positive groups, respectively. The incidence of metachronous cancer was higher in the <jats:italic>Hp<\/jats:italic>\u2010positive group than in the <jats:italic>Hp<\/jats:italic>\u2010negative group (<jats:italic>p<\/jats:italic>\u2009=\u20090.035, log\u2010rank test). In a multivariate analysis, persistent <jats:italic>Hp<\/jats:italic> infection was an independent risk factor for metachronous GC (age\u2010 and sex\u2010adjusted hazard ratio, 2.33; 95% CI: 1.05\u20135.17).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Persistent <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection status was associated with a higher risk of metachronous GC, and <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> treatment needs to be provided in elderly patients aged \u2265\u200975\u2009years and older with EGC undergoing ESD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.70068","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T03:35:26Z","timestamp":1756784126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp><i>Helicobacter pylori<\/i><\/scp> Infection and Metachronous Gastric Cancer in Elderly Patients With Gastric Cancer Aged \u2265\u200975\u2009Years Who Underwent Endoscopic Submucosal Dissection"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2614-3419","authenticated-orcid":false,"given":"Young\u2010Il","family":"Kim","sequence":"first","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center  Goyang Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Yeul","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center  Goyang 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