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

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

BACKGROUND: 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.

OBJECTIVE: To characterize EG malignancies after bariatric procedures.

SETTING: University Hospital, United Kingdom.

METHODS: We performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition.

RESULTS: 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.

CONCLUSION: 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.

Bariatric surgery, Esophageal cancer, Esophagogastric cancer, Gastric cancer, Metabolic surgery
1550-7289
464-472
Parmar, Chetan
89e77135-487a-4e12-9962-05dd7b5320b2
Zakeri, Roxanna
0b5e2a2a-afa4-4f43-a532-3fca682507c8
Abouelazayem, Mohamed
e9174b78-3dc5-4160-83b1-31fc669a7e88
Shin, Thomas H
a0a454eb-9ad3-4990-aba5-c290c5d5f44f
Aminian, Ali
689ea0ef-99fc-491f-a016-c19e6a1b4813
Mahmoud, Tala
5eb0b253-b7f3-46ac-97e0-d3ca87d1a9f3
Abu Dayyeh, Barham K
e2fc6356-5322-4d68-8d47-af376b696cc9
Wee, Melissa Y
0ba3a0e9-37b4-4568-8817-15f389fe4d77
Fischer, Laura
6fa251d7-bbdb-4917-b1d9-f3af2bdb0bc1
Daams, Freek
bfff7bf3-3b8e-400b-bbdc-1dc5183ffe3e
Mahawar, Kamal
5b4d6db4-7956-47fa-9495-4b052664c82b
Underwood, Timothy
8e81bf60-edd2-4b0e-8324-3068c95ea1c6
OGMOS Study Group
Parmar, Chetan
89e77135-487a-4e12-9962-05dd7b5320b2
Zakeri, Roxanna
0b5e2a2a-afa4-4f43-a532-3fca682507c8
Abouelazayem, Mohamed
e9174b78-3dc5-4160-83b1-31fc669a7e88
Shin, Thomas H
a0a454eb-9ad3-4990-aba5-c290c5d5f44f
Aminian, Ali
689ea0ef-99fc-491f-a016-c19e6a1b4813
Mahmoud, Tala
5eb0b253-b7f3-46ac-97e0-d3ca87d1a9f3
Abu Dayyeh, Barham K
e2fc6356-5322-4d68-8d47-af376b696cc9
Wee, Melissa Y
0ba3a0e9-37b4-4568-8817-15f389fe4d77
Fischer, Laura
6fa251d7-bbdb-4917-b1d9-f3af2bdb0bc1
Daams, Freek
bfff7bf3-3b8e-400b-bbdc-1dc5183ffe3e
Mahawar, Kamal
5b4d6db4-7956-47fa-9495-4b052664c82b
Underwood, Timothy
8e81bf60-edd2-4b0e-8324-3068c95ea1c6

OGMOS Study Group (2022) Esophageal and gastric malignancies after bariatric surgery: a retrospective global study. Surgery for Obesity and Related Diseases, 18 (4), 464-472. (doi:10.1016/j.soard.2021.11.024).

Record type: Article

Abstract

BACKGROUND: 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.

OBJECTIVE: To characterize EG malignancies after bariatric procedures.

SETTING: University Hospital, United Kingdom.

METHODS: We performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition.

RESULTS: 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.

CONCLUSION: 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.

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More information

e-pub ahead of print date: 3 December 2021
Published date: 24 March 2022
Keywords: Bariatric surgery, Esophageal cancer, Esophagogastric cancer, Gastric cancer, Metabolic surgery

Identifiers

Local EPrints ID: 456189
URI: http://eprints.soton.ac.uk/id/eprint/456189
ISSN: 1550-7289
PURE UUID: e97fe584-9512-4b0e-96e1-a0a8aa43c698
ORCID for Timothy Underwood: ORCID iD orcid.org/0000-0001-9455-2188

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Date deposited: 26 Apr 2022 16:36
Last modified: 28 Apr 2022 01:52

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Contributors

Author: Chetan Parmar
Author: Roxanna Zakeri
Author: Mohamed Abouelazayem
Author: Thomas H Shin
Author: Ali Aminian
Author: Tala Mahmoud
Author: Barham K Abu Dayyeh
Author: Melissa Y Wee
Author: Laura Fischer
Author: Freek Daams
Author: Kamal Mahawar
Corporate Author: OGMOS Study Group

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