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Malignancy in bariatric surgery patients: a French multisite cohort

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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

Abbreviations

BMI:

Body mass index

CPAP:

Continuous positive airway pressure

EWL:

Excess weight loss

IQR:

Interquartile range

OSAS:

Obstructive sleep apnea syndrome

SD:

Standard deviation

TWL:

Total weight loss

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Correspondence to Martin Gaillard.

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Disclosures

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). https://doi.org/10.1007/s00464-020-08091-5

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  • DOI: https://doi.org/10.1007/s00464-020-08091-5

Keywords

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