Esophageal and gastric malignancies after bariatric surgery: a retrospective global study |
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| Affiliation: | 1. Department of Surgery, Whittington Health NHS Trust, London, UK;2. Centre for Obesity Research, University College, London, UK;3. Department of Surgery, St George’s University Hospitals NHS Foundation Trust, London, UK;4. Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio;5. Department of Gastroenterology, Mayo Clinic, Rochester, Minnesota;6. Department of Oesophagogastric Surgery, Flinders Medical Centre, Adelaide, Australia;7. Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma;8. Department of Surgery, Amsterdam UMC, VUmc, Amsterdam, The Netherlands;9. Department of Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK;1. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan;2. Center for Obesity, Life Style, and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan;3. Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan;4. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;5. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;6. Metabolic and Weight Management Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;7. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan;8. Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan;1. Department of Digestive and Bariatric Surgery, Geoffroy Saint Hilaire Clinic, Ramsay Santé, Paris, France;2. ELSAN, Obesity Surgical Center, Saint Michel Clinic, Toulon, France;3. Department of Digestive and Bariatric Surgery, Madonna della Salute Clinic, Porto Viro, Italy;1. Department of General, Visceral and Transplant Surgery, Heidelberg University Hospital, Heidelberg, Germany;2. Department of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Heidelberg University Hospital, Heidelberg, Germany;3. Department of Endocrinology and Metabolism, Heidelberg University Hospital, Heidelberg, Germany;4. Department of Nephrology, Heidelberg University Hospital, Heidelberg, Germany;5. Department of Gastroenterology, Infectious Diseases and Intoxication, Heidelberg University Hospital, Heidelberg, Germany;6. Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany;1. Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur Delafontaine, 93200 Saint-Denis, France;2. Department of gastroenterology, hôpital Avicenne AP–HP, route de Stalingrad, 93000 Bobigny, France;1. Department of Surgery, University of California, Davis, Sacramento, California;2. Department of Surgery, Oregon Health & Science University, Portland, Oregon;3. Department of Surgery, University of California, San Francisco, San Francisco, California |
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| Abstract: | BackgroundBariatric surgery can influence the presentation, diagnosis, and management of gastrointestinal cancers. Esophagogastric (EG) malignancies in patients who have had a prior bariatric procedure have not been fully characterized.ObjectiveTo characterize EG malignancies after bariatric procedures.SettingUniversity Hospital, United Kingdom.MethodsWe performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition.ResultsThis study includes 170 patients from 75 centers in 25 countries who underwent bariatric procedures between 1985 and 2020. At the time of the bariatric procedure, the mean age was 50.2 ± 10 years, and the mean weight 128.8 ± 28.9 kg. Women composed 57.3% (n = 98) of the population. Most (n = 64) patients underwent a Roux-en-Y gastric bypass (RYGB) followed by adjustable gastric band (AGB; n = 46) and sleeve gastrectomy (SG; n = 43). Time to cancer diagnosis after bariatric surgery was 9.5 ± 7.4 years, and mean weight at diagnosis was 87.4 ± 21.9 kg. The time lag was 5.9 ± 4.1 years after SG compared to 9.4 ± 7.1 years after RYGB and 10.5 ± 5.7 years after AGB. One third of patients presented with metastatic disease. The majority of tumors were adenocarcinoma (82.9%). Approximately 1 in 5 patients underwent palliative treatment from the outset. Time from diagnosis to mortality was under 1 year for most patients who died over the intervening period.ConclusionThe Oesophago-Gastric Malignancies After Obesity/Bariatric Surgery study presents the largest series to date of patients developing EG malignancies after bariatric surgery and attempts to characterize this condition. |
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| Keywords: | Bariatric surgery Esophagogastric cancer Metabolic surgery Gastric cancer Esophageal cancer |
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