Esophageal and gastric malignancies after bariatric surgery: a retrospective global study

Bariatric 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. To characterize EG malignancies after bariatric procedures. University Ho...

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Published in:	Surgery for obesity and related diseases Vol. 18; no. 4; pp. 464 - 472
Main Authors:	Parmar, Chetan, Zakeri, Roxanna, Abouelazayem, Mohamed, Shin, Thomas H., Aminian, Ali, Abu Dayyeh, Barham K., Wee, Melissa Y., Fischer, Laura, Daams, Freek, Mahawar, Kamal, Agustin, Cataldo, Fuente, Ignacio, Carbajo, Miguel, Cal, Patricio, Chisholm, Jacob, Tan, Michael H.L., Gan, Philip, Gananadha, Sivakumar, Felsenreich, Daniel M., Prager, Gerhard, Matthys, Chris, Himpens, Jacques M., Focquet, Marc A.M.R.M., Ramos, Almino, Nato, Manoel Galvano, Vidal, Thiago, Andalib, Amin, Siblini, Aya, Ferri, Lorenzo, Abdarabo, Lina, Pescarus, Radu, Yang, Wah, Hamed, Hosam, Bergeat, Damien, Marie, De Montrichard, Martini, Francesco, Regis, François, Genser, Laurent, Skalli, Mehdi, Nedelcu, Marius, Smejkal, Milan, Kassir, Radwan, Nicolas, Regenet, Stier, Christine, Kermansaravi, Mohammad, Raziel, Asnat, Sakran, Nasser, Oldani, Alberto, Boru, Cristian Eugeniu, Mécheri, Fouzia, Ciccarese, Francesca, Cesana, Giovanni Carlo, Musella, Mario, Foletto, Mirto, Auricchio, Pasquale, Olmi, Stefano, Seki, Yosuke, Van 'T Hof, Gerhard, Hart, Judith W.H., Van De Sande, Justin S.L., Takkenberg, Marijn, Snoekx, Rob, Plat, Victor D., Kalinowski, Piotr, Nabais, Celso, Al-Bahrani, Ahmed Z., Al Zoubi, Mohammad, Bettonica, Carla, Osorio, Javier, Tejedor-Tejada, Javier, Sanz, Lourdes M., Cuadrado, Marta, Moorjani, Rajesh Gianchandani, Suter, Michel, Borbély, Yves, Barajas-Gamboa, Juan S., Kroh, Matthew, Kisiel, Aaron P., Kamocka, Anna, Immanuel, Arul, Sgromo, Bruno, Gopinath, Bussa, Khoo, David, Mukherjee, Samrat, Pournaras, Dimitrios, Underwood, Tim, Griffiths, Ewen A., Miller, Glenn V., Jaretzke, Helen, Dmitrewski, Jan, Gillies, Richard S., Singhal, Rishi, Preston, Shaun R., Robinson, Steven John, Hawkins, William J., Adamo, Marco, El Kalaawy, Mohamed, Gossage, James, Crawford, Christopher B., Jaruvongvanich, Veeravich
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-04-2022
Subjects:	Adult Bariatric surgery Bariatric Surgery - adverse effects Bariatric Surgery - methods Esophageal cancer Esophagogastric cancer Female Gastrectomy - adverse effects Gastrectomy - methods Gastric Bypass - adverse effects Gastric Bypass - methods Gastric cancer Humans Metabolic surgery Middle Aged Obesity, Morbid - surgery Retrospective Studies Stomach Neoplasms - epidemiology Stomach Neoplasms - etiology Stomach Neoplasms - surgery Treatment Outcome Metabolic surgery Gastric cancer Esophageal cancer Bariatric surgery Esophagogastric cancer
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Summary:	Bariatric 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. To characterize EG malignancies after bariatric procedures. University Hospital, United Kingdom. We performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition. This 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. The 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. ▪This is the largest series of patients developing OG cancer after bariatric surgery.▪OG cancers were diagnosed at a mean of 9.5 ± 7.4 years (range 1 – 44 years) from BS.▪One-third of the patients presented with distant metastasis at the time of diagnosis.▪Approximately 1 in 5 patients underwent palliative treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1550-7289 1878-7533
DOI:	10.1016/j.soard.2021.11.024