HEALTH

Bariatric Surgery Could presumably fair Reduce back Risk of Esophageal, Gastric Cancers

— Cohort peep offers “reassurance of the protective medical advantages of weight loss surgery”

by
Kristen Monaco, Crew Author, MedPage This day

Present process bariatric surgery for extreme weight problems became linked to a lowered incidence of esophageal and gastric cancer and total in-hospital mortality, a French cohort peep confirmed.

Among largely ladies, the incidence rates of these cancers were 4.9 per 100,000 population per year for the neighborhood who underwent bariatric surgery versus 6.9 per 100,000 population per year for these that didn’t endure surgery, for an incidence price ratio of 1.42 (95% CI 1.11-1.82, P=0.005), reported Andrea Lazzati, MD, PhD, of the Centre Hospitalier Intercommunal de Créteil in France, and colleagues.

This inequity became confirmed in a multivariable Cox proportional hazards regression mannequin, with a hazard ratio for bariatric surgery of 0.76 (95% CI 0.59-0.98, P=0.03). Total mortality became additionally critically lower within the surgery neighborhood (HR 0.60, 95% CI 0.56-0.64, P<0.001), the authors infamous in JAMA Surgery.

“Apparently the balance between protective factors (weight loss, metabolic results, and eradication of H. pylori an infection) and threat factors (GERD [gastroesophageal reflux disease] and bile reflux) for cancer after bariatric surgery is in prefer of protective factors,” Lazzati’s neighborhood wrote.

Of present, within the regression mannequin, a predominant reduction in cancer incidence became no longer viewed with adjustable gastric banding (HR 0.84, 95% CI 0.47-1.51, P=0.56) or sleeve gastrectomy (HR 0.86, 95% CI 0.63-1.18, P=0.35) when put next with the place watch over neighborhood, however the researchers did win a predominant reduction in cancer incidence after gastric bypass (HR 0.62, 95% CI 0.40-0.95, P=0.02).

These findings help as “an extraordinarily out of the ordinary step against bettering the realizing of skill lifetime dangers of bariatric surgery and total main health advantages of surgically triggered weight loss,” infamous Piotr Gorecki, MD, and Michael Zenilman, MD, both of Weill Cornell Treatment in Unusual York Metropolis, in an accompanying commentary.

Whereas there has been “increasing predicament” that these standard bariatric procedures may maybe presumably well lead to an uptick in adenocarcinomas ensuing from their association with GERD and subsequent development to Barrett esophagus, this peep now offers both patients and clinicians with “reassurance of the protective medical advantages of weight loss surgery,” they wrote.

Alternatively, longer-length of time analysis are aloof wanted, Gorecki and Zenilman urged, noting that all of these cancers may maybe presumably well decide years to blueprint.

That is no longer basically the main peep to present a protective earnings against cancer with bariatric surgery. The SPLENDID peep, which became equipped at the American Diabetes Association meeting remaining year, confirmed a 32% diminished threat in 10-year weight problems-associated cancer incidence following weight loss with bariatric surgery. This peep included a composite of 13 cancer kinds, including esophageal adenocarcinoma and cancer of the gastric cardia.

For the original cohort peep, Lazzati and group light records from a nationwide discharge database, which included all surgical centers, in France from January 2010 thru December 2017. They included 303,709 patients who underwent bariatric surgery (mean age 40.2, 80.9% ladies) matched with 605,140 patients who had extreme weight problems however didn’t endure bariatric surgery (mean age 40.4, 82.8% ladies).

Indicate put together-up time became 6.06 years within the surgery neighborhood and 5.62 years within the place watch over neighborhood. A total of 337 patients had esophagogastric cancer: 83 within the surgery neighborhood and 254 within the place watch over neighborhood.

  • creator['full_name']

    Kristen Monaco is a bunch creator, specializing in endocrinology, psychiatry, and nephrology news. Based mostly fully out of the Unusual York Metropolis place of work, she’s labored at the firm since 2015.

Disclosures

Lazzati and co-authors reported relationships with Johnson & Johnson, Medtronic, Gore, BariaTek, and Novo Nordisk.

Zenilman reported relationships with Academic Scientific Mavens Insurance and the Mohamed & Obaid Almulla Crew. Gorecki reported no disclosures.

Well-known Source

JAMA Surgery

Source Reference: Lazzati A, et al “Risk of esophageal and gastric cancer after bariatric surgery” JAMA Surg 2023; DOI: 10.1001/jamasurg.2022.6998.

Secondary Source

JAMA Surgery

Source Reference: Gorecki PJ, Zenilman ME “Does bariatric surgery develop the threat of gastroesophageal cancer?” JAMA Surg 2023; DOI: 10.1001/jamasurg.2022.6999.

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