Gastrectomy is known as one of the risk factors for tuberculosis (TB). However, there is no study about the association between TB development and gastrectomy performed in patients with early gastric cancer (EGC). The study is aimed at evaluating conventional risk factors including gastrectomy associated with TB development in patients with EGC.
A retrospective cohort study was performed, using database of the Center for Gastric Cancer of National Cancer Center, Korea. The patients with EGC whose T1 lesions were pathologically confirmed by gastrectomy or endoscopic resection were included.
A total of 1,935 patients constituted the EGC cohort. Of these, 1,495 patients were confirmed by gastrectomy and the rest 440 by endoscopic resection. The median follow-up duration was 4.9 years and during this period, 31 cases of TB developed (TB incidence 334/100,000 person-year, 95% CI 227-475). Multivariate Cox regression analysis showed that old TB lesion on chest radiograph and gastrectomy were significant risk factors (HR 5.01, 95% CI 2.44-10.28, P<0.001, and HR 8.95, 95% CI 1.22-65.78, P=0.031, respectively). In the gastrectomy subgroup, old TB lesion, ≥15% reductions in weight and albumin level about one year after gastrectomy were significant risk factors (HR 4.80, 95% CI 2.26-10.18, P<0.001, HR 3.08, 95% CI 1.47-6.48, P=0.003, and HR 5.02, 95% CI 1.47-17.12, P=0.010, respectively).
Old TB lesion and gastrectomy were significant risk factors in the EGC cohort. In addition, old TB lesion and ≥15% post-op reductions in weight and albumin level were significant risk factors in the gastrectomy subgroup