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Malignancy in bariatric surgery patients: a French multisite cohort



Bariatric surgery is associated with decreased cancer-related mortality. An indefinite proportion of patients that undergo bariatric surgery have a history of malignancy or will develop cancer. In these patients, weight loss and oncologic evolution needed to be assessed. The aim of this study was to report the results of patients diagnosed with malignancy before and after bariatric surgery in a French multisite cohort.


We conducted a retrospective cohort study of all patients who underwent bariatric surgery in six university centers. Patients were divided in two groups: patients with a preoperative history of malignancy and patients diagnosed with malignancy during the follow-up. Both groups were compared with control groups of patients that underwent surgery during the same period.


From 2008 to 2018, 8927 patients underwent bariatric surgery. In patients with a history of malignancy (n = 90), breast and gynecologic cancers were predominant (37.8%). Median interval between malignancy and surgery was 60 (38–118) months. After a follow-up of 24 (4–52) months, 4 patients presented with cancer recurrence. Comparative analysis demonstrated equivalent weight loss one year after surgery. In patients with postoperative malignancy (n = 32), breast and gynecologic cancers were also predominant (40.6%). Median interval between surgery and malignancy was 22 (6–109) months. In the comparative analysis, weight loss was similar at 2 years.


History of malignancy should not be considered as an absolute contraindication for bariatric surgery. Gynecological cancer screening should be reinforced before and after surgery. The development of malignancy postoperatively does not seem to affect mid-term bariatric outcomes.

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Fig. 1



Body mass index


Continuous positive airway pressure


Excess weight loss


Interquartile range


Obstructive sleep apnea syndrome


Standard deviation


Total weight loss


  1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384:766–781

    Article  Google Scholar 

  2. Fang X, Wei J, He X, Lian J, Han D, An P, Zhou T, Liu S, Wang F, Min J (2018) Quantitative association between body mass index and the risk of cancer: a global meta-analysis of prospective cohort studies. Int J Cancer 143:1595–1603

    CAS  Article  Google Scholar 

  3. Jee SH, Sull JW, Park J, Lee SY, Ohrr H, Guallar E, Samet JM (2006) Body-mass index and mortality in Korean men and women. N Engl J Med 355:779–787

    CAS  Article  Google Scholar 

  4. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371:569–578

    Article  Google Scholar 

  5. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591

    CAS  Article  Google Scholar 

  6. Park J, Morley TS, Kim M, Clegg DJ, Scherer PE (2014) Obesity and cancer—mechanisms underlying tumour progression and recurrence. Nat Rev Endocrinol 10:455–465

    CAS  Article  Google Scholar 

  7. Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Agren G, Carlsson LM (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357:741–752

    Article  Google Scholar 

  8. Schauer DP, Feigelson HS, Koebnick C, Caan B, Weinmann S, Leonard AC, Powers JD, Yenumula PR, Arterburn DE (2017) Association between weight loss and the risk of cancer after bariatric surgery. Obesity (Silver Spring Md) 25(Suppl 2):S52–S57

    Google Scholar 

  9. Schauer DP, Feigelson HS, Koebnick C, Caan B, Weinmann S, Leonard AC, Powers JD, Yenumula PR, Arterburn DE (2019) Bariatric surgery and the risk of cancer in a large multisite cohort. Ann Surg 269:95–101

    Article  Google Scholar 

  10. Sjostrom L, Gummesson A, Sjostrom CD, Narbro K, Peltonen M, Wedel H, Bengtsson C, Bouchard C, Carlsson B, Dahlgren S, Jacobson P, Karason K, Karlsson J, Larsson B, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Carlsson LM (2009) Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 10:653–662

    Article  Google Scholar 

  11. Bailly L, Fabre R, Pradier C, Iannelli A (2020) Colorectal cancer risk following bariatric surgery in a nationwide study of French individuals with obesity. JAMA Surg 155(5):395–402

    Article  Google Scholar 

  12. Felsenreich DM, Ladinig LM, Beckerhinn P, Sperker C, Schwameis K, Krebs M, Jedamzik J, Eilenberg M, Bichler C, Prager G, Langer FB (2018) Update: 10 years of sleeve gastrectomy—the first 103 patients. Obes Surg 28:3586–3594

    Article  Google Scholar 

  13. Mackenzie H, Markar SR, Askari A, Faiz O, Hull M, Purkayastha S, Moller H, Lagergren J (2018) Obesity surgery and risk of cancer. Br J Surg 105:1650–1657

    CAS  Article  Google Scholar 

  14. Welbourn R, Hollyman M, Kinsman R, Dixon J, Liem R, Ottosson J, Ramos A, Vage V, Al-Sabah S, Brown W, Cohen R, Walton P, Himpens J (2019) Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg 29:782–795

    Article  Google Scholar 

  15. Charles-Nelson A, Lazzati A, Katsahian S (2020) Analysis of trajectories of care after bariatric surgery using data mining method and health administrative information systems. Obes Surg 30:2206–2216

    Article  Google Scholar 

  16. Haute Autorité de Santé (2009) Obésité : Prise en charge chirurgicale chez l’adulte. Haute Autorité de Santé. Accessed 1 Mar 2020

  17. Institut National du Cancer (2018) Les cancers en France, édition 2017, collection Les Données. Institut National du Cancer. Accessed 1 Mar 2020

  18. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  Google Scholar 

  19. Warburg O, Wind F, Negelein E (1927) The metabolism of tumors in the body. J Gen Physiol 8:519–530

    CAS  Article  Google Scholar 

  20. Gagne DJ, Papasavas PK, Maalouf M, Urbandt JE, Caushaj PF (2009) Obesity surgery and malignancy: our experience after 1500 cases. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 5:160–164

    Article  Google Scholar 

  21. Ghiassi S, El Chaar M, Aleassa EM, Moustarah F, El Djouzi S, Birriel TJ, Rogers AM (2020) ASMBS position statement on the relationship between obesity and cancer, and the role of bariatric surgery: risk, timing of treatment, effects on disease biology, and qualification for surgery. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 16(6):713–724

    Article  Google Scholar 

  22. Strain GW, Cooley V, Ebel F, Christos P (2020) Weight loss after bariatric surgery in cancer survivors. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 16:670–673

    Article  Google Scholar 

  23. Gartner D, Stroh C, Hukauf M, Benedix F, Manger T (2019) Sleeve gastrectomy in the German Bariatric Surgery Registry from 2005 to 2016: perioperative and 5-year results. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 15:187–193

    Article  Google Scholar 

  24. Sohn S, Fischer J, Booth M (2017) Adenocarcinoma of the gastro-oesophageal junction after sleeve gastrectomy: a case report. ANZ J Surg 87:E163-e164

    Article  Google Scholar 

  25. Société Française et Francophone de Chirurgie de l’Obésité et des Maladies Métaboliques (2018) Surveillance endoscopique après sleeve gastrectomy et bypass en oméga définie par la SOFFCO.MM. Société Française et Francophone de Chirurgie de l’Obésité et des Maladies Métaboliques. Accessed 1 Mar 2020

  26. Derogar M, Hull MA, Kant P, Ostlund M, Lu Y, Lagergren J (2013) Increased risk of colorectal cancer after obesity surgery. Ann Surg 258:983–988

    Article  Google Scholar 

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Correspondence to Martin Gaillard.

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Drs. Tranchart, Gaillard, Kassir, Gronnier, Moszkowicz, Ben Amor, Lainas, Savala, Meunier, Le Roux, Degrandi, Baratte, Vychnevskaia, Gugenheim and Dagher have no conflicts of interest or financial ties to disclose.

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Tranchart, H., Gaillard, M., Kassir, R. et al. Malignancy in bariatric surgery patients: a French multisite cohort. Surg Endosc 35, 6021–6030 (2021).

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  • Obesity
  • Morbid
  • Bariatric surgery
  • Neoplasms
  • Cohort studies
  • Weight loss