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Risk of Esophageal Adenocarcinoma After Bariatric Surgery: A Meta-Analysis of Retrospective Studies

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Abstract

Purpose

This study aims to systematically review and meta-analyze the evidence on the risk of esophageal adenocarcinoma (EAC) following metabolic and bariatric surgery (MBS).

Materials and Methods

A systematic literature search was conducted on the China National Knowledge Infrastructure (CNKI), Wanfang, EMBASE, MEDLINE, Web of Science, The Cochrane Library, and PubMed databases. Meta-analysis utilized odds ratios (ORs) and 95% confidence intervals (CIs) to analyze the correlation between MBS and the risk of EAC. Meta-analysis was performed using STATA software (version 12.0).

Results

Fourteen studies involving patients with obesity undergoing bariatric surgery and control groups receiving conventional treatment were included. The meta-analysis indicated a reduction in the overall incidence of esophageal cancer after bariatric surgery (OR = 0.69, 95% CI: 0.51–0.95, P = 0.022). Subgroup analysis results demonstrated a decreased risk of EAC in European patients with obesity undergoing MBS treatment (OR: 0.60, 95% CI: 0.38–0.95, P = 0.028). In studies with a sample size greater than or equal to 100,000 patients, the risk of EAC in patients with obesity undergoing MBS was significantly lower than the non-surgery group (OR: 0.59, 95% CI: 0.42–0.83, P = 0.003). Articles published before 2020 and those published in 2020 or earlier showed a significant difference in the incidence of EAC between the surgery and non-surgery groups (OR: 0.57, 95% CI: 0.43–0.75, P < 0.001). The risk of EAC in patients with obesity with a follow-up time of less than 5 years was statistically significant (OR: 0.46, 95% CI: 0.25–0.82, P = 0.009).

Conclusion

Our meta-analysis results suggest a reduced risk of esophageal cancer in patients with obesity after bariatric surgery.

PROSPERO Registration

CRD 42024505177.

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Data Availability

Some or all data, models, or code generated or used during the study are available from the corresponding author by request.

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Funding

This work was supported by the Natural Science Foundation of Gansu Province (grant number 23JRRA1317, 23JRRA1782).

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Author notes

  1. Chenglou Zhu and Wenhan Liu contributed equally to this work.

Authors and Affiliations

  1. The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China

    Chenglou Zhu & Lingzhi Peng

  2. Department of Anorectal Surgery, Gansu Provincial Hospital, Lanzhou, 730000, China

    Wenhan Liu & Dongping Hu

  3. Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, China

    Chenglou Zhu & Lingzhi Peng

Authors
  1. Chenglou Zhu
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  4. Lingzhi Peng
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Contributions

ZCL and LWH made substantial contributions to the conception and design for this work. ZCL and PLZ collected all the data. ZCL and LWH were the major contributors in writing the manuscript. ZCL and HDP performed the critical revision for this manuscript. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Wenhan Liu.

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Key Points

• Question: Is there an association between bariatric surgery and the incidence of esophageal cancer?

• Findings: In this meta-analysis, a total of 4,665,963 patients were included (1,081,152 patients who underwent bariatric surgery and 3,584,811 matched non-surgery control group patients). Bariatric surgery was significantly associated with a lower risk of esophageal cancer (OR = 0.69, 95% CI: 0.51–0.95, P = 0.022).

• Meanings: Among patients with obesity, bariatric surgery is associated with a significantly reduced incidence of esophageal cancer compared to non-surgical interventions.

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Zhu, C., Liu, W., Hu, D. et al. Risk of Esophageal Adenocarcinoma After Bariatric Surgery: A Meta-Analysis of Retrospective Studies. OBES SURG 34, 1726–1736 (2024). https://doi.org/10.1007/s11695-024-07190-9

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  • DOI: https://doi.org/10.1007/s11695-024-07190-9

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