{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:54:44Z","timestamp":1784649284516,"version":"3.55.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea","doi-asserted-by":"crossref","award":["2023IT0012"],"award-info":[{"award-number":["2023IT0012"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Hanmi pharmaceutical Co.,Ltd"},{"name":"sponsored research funds provided by Mr. Hyeonho Kim"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Limited research has examined the direct effectiveness of <jats:italic>Helicobacter pylori<\/jats:italic> eradication (HPE) on the remnant stomach neoplasms after curative gastrectomy. This study aims to assess whether HPE could prevent the development of gastric neoplasms in the remnant stomach after curative gastrectomy through a double-blinded, randomized controlled trial.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>After curative gastrectomy, patients with HP infection and pathologically proven stage 1 tumors will be enrolled and randomly assigned to eradication (n\u2009=\u2009492) and placebo (n\u2009=\u2009492) groups. Patients in the eradication arm will be given the eradication regimen, which will comprise 40\u2009mg of esomeprazole, 1\u2009g of amoxicillin, and 500\u2009mg of clarithromycin twice a day for 14 days. The primary endpoint is the development of gastric neoplasms, including adenoma or adenocarcinoma. The secondary endpoints are the 10-year overall survival, improvement rates of gastric glandular atrophy and\/or intestinal metaplasia, and incidence of new-onset hyperplastic polyps among the groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Significance<\/jats:title>\n<jats:p>This research will be the first randomized controlled clinical study in which a thorough long-term follow-up will be needed to evaluate the effectiveness of HPE for remnant stomach neoplasms after curative gastrectomy. Its results will serve as a basis for developing future strategies in the management of patients with HP infection who undergo curative gastrectomy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/cris.nih.go.kr\/\" xlink:type=\"simple\">https:\/\/cris.nih.go.kr\/<\/jats:ext-link> KCT0008855. October 10, 2023.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0320903","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T18:00:03Z","timestamp":1747677603000},"page":"e0320903","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Helicobacter pylori eradication on remnant stomach neoplasms after curative gastrectomy (HELP-GC): Protocol of a HELP-GC randomized controlled trial"],"prefix":"10.1371","volume":"20","author":[{"given":"Chang Seok","family":"Ko","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Hee","family":"Noh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Soo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Hwan","family":"Yook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwoon-Yong","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-0140","authenticated-orcid":true,"given":"In-Seob","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Yong","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Sung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"issue":"16","key":"pone.0320903.ref001","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1056\/NEJM199110173251604","article-title":"Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii","volume":"325","author":"A Nomura","year":"1991","journal-title":"N Engl J Med"},{"issue":"16","key":"pone.0320903.ref002","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1056\/NEJM199110173251603","article-title":"Helicobacter pylori infection and the risk of gastric carcinoma","volume":"325","author":"J Parsonnet","year":"1991","journal-title":"N Engl J Med"},{"issue":"11","key":"pone.0320903.ref003","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1056\/NEJMoa001999","article-title":"Helicobacter pylori infection and the development of gastric cancer","volume":"345","author":"N Uemura","year":"2001","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0320903.ref004","article-title":"Effect of Helicobacter pylori Eradication on Gastric Cancer Prevention: Updated Report From a Randomized Controlled Trial With 26.5 Years of Follow-up","volume":"163","author":"L Yan","year":"2022","journal-title":"Gastroenterology"},{"issue":"12","key":"pone.0320903.ref005","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1056\/NEJMoa1708423","article-title":"Helicobacter pylori Therapy for the Prevention of Metachronous Gastric Cancer","volume":"378","author":"IJ Choi","year":"2018","journal-title":"N Engl J Med"},{"issue":"9636","key":"pone.0320903.ref006","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/S0140-6736(08)61159-9","article-title":"Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial","volume":"372","author":"K Fukase","year":"2008","journal-title":"Lancet"},{"issue":"5","key":"pone.0320903.ref007","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/apt.12402","article-title":"Randomised clinical trial: the effects ofHelicobacter pylorieradication on glandular atrophy and intestinal metaplasia after subtotal gastrectomy for gastric cancer","volume":"38","author":"S-J Cho","year":"2013","journal-title":"Aliment Pharmacol Ther"},{"key":"pone.0320903.ref008","first-page":"1051","article-title":"Effect of Helicobacter pylori eradication after subtotal gastrectomy on the survival rate of patients with gastric cancer: follow-up for up to 15 years. 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