{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:19:13Z","timestamp":1788149953861,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n The prognostic significance of\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n (\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n ) infection in metastatic colorectal cancer (mCRC) remains uncertain. Most prior studies have focused on colorectal neoplasia risk and have relied on serological markers rather than assessment of active infection. We evaluated the association between histologically confirmed\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n status and clinicopathological features, systemic inflammatory markers, and survival outcomes in patients with de novo mCRC.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this retrospective single\u2010center cohort study, consecutive patients diagnosed with de novo mCRC between September 2011 and December 2025 who underwent synchronous upper gastrointestinal endoscopy at diagnosis were included.\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n status was determined histopathologically. Overall survival (OS) was estimated using the Kaplan\u2013Meier method and compared with the log\u2010rank test. Prognostic factors were analyzed using univariable and multivariable Cox proportional hazards models with prespecified sensitivity and exploratory interaction analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 168 patients, 77 (46%) were\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n positive. Right\u2010sided tumors were more frequent in\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n \u2013positive patients (43% vs. 17%,\n p<\/jats:italic>\n \u2009<\u20090.001), as was BRAF mutation (12% vs. 3%,\n p<\/jats:italic>\n \u2009=\u20090.044). Baseline neutrophil\u2010to\u2010lymphocyte ratio was higher in the\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n \u2013positive group (median 4.34 vs. 2.74,\n p<\/jats:italic>\n \u2009=\u20090.002). Median OS was longer in\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n \u2013positive patients (33 vs. 19\u2009months; log\u2010rank\n p<\/jats:italic>\n \u2009<\u20090.001). In multivariable analysis, right\u2010sided tumor localization (HR 2.11, 95% CI: 1.648\u20132.716;\n p<\/jats:italic>\n \u2009<\u20090.001), RAS mutation (HR 1.94, 95% CI: 1.612\u20132.794;\n p<\/jats:italic>\n \u2009<\u20090.001), and\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n negativity (HR 1.94, 95% CI: 1.569\u20132.812;\n p<\/jats:italic>\n \u2009<\u20090.001) remained statistically significant. These findings were consistent across sensitivity analyses. Significant interactions were observed for tumor sidedness (\n p<\/jats:italic>\n \u2009<\u20090.001) and NLR category (\n p<\/jats:italic>\n \u2009=\u20090.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Histologically confirmed\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n positivity was associated with a distinct clinicopathological profile and longer overall survival in patients with de novo mCRC. Given the observational design, these findings should be interpreted as hypothesis\u2010generating and require validation in prospective and multi\u2010center studies.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hel.70150","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:26:42Z","timestamp":1783402002000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Active\n Helicobacter pylori<\/i>\n Infection and Survival Outcomes in De Novo Metastatic Colorectal Cancer: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"31","author":[{"given":"Sait","family":"Kitapli","sequence":"first","affiliation":[{"name":"Medical Oncology Clinic Mugla Education and Research Hospital Mugla Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alkan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Mugla Sitki Kocman University Faculty of Medicine Mugla Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0598-7284","authenticated-orcid":false,"given":"Ozgur","family":"Tanriverdi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Mugla Sitki Kocman University Faculty of Medicine Mugla 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