The prognostic significance of Helicobacter pylori (H. pylori) 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 H. pylori status and clinicopathological features, systemic inflammatory markers, and survival outcomes in patients with de novo mCRC. In this retrospective single-center 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.
H. pylori status was determined histopathologically. Overall survival (OS) was estimated using the Kaplan-Meier method and compared with the log-rank test. Prognostic factors were analyzed using univariable and multivariable Cox proportional hazards models with prespecified sensitivity and exploratory interaction analyses. Among 168 patients, 77 (46%) were H. pylori positive.
Right-sided tumors were more frequent in H. pylori-positive patients (43% vs. 17%, p
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