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Oesophageal and Gastric Cancer After Bariatric Surgery: an Up-to-Date Systematic Sco** Review of Literature of 324 Cases

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Abstract

Background

This review aimed to give an updated overview of the occurrence, diagnosis, treatment and outcome of oesophageal and gastric cancer after bariatric and metabolic surgery (BMS).

Methods

Two searches were done (one for original studies and one for systematic reviews) using an adapted form of “sco** review methodology”. MEDLINE, Embase, CINAHL, Pubmed and the Cochrane Library were searched for studies on patients with either oesophageal or gastric cancer after BMS.

Results

A total of 52 unique studies were included which reported on 324 patients, which included 110 (34%) males and 136 (42%) females. In the remaining 78 patients, gender was not specified. A mean of 62.95 ± 32.75 months was the time from BMS to diagnosis of cancer. Most of the patients had a Roux-en-Y gastric bypass (RYGB) as index bariatric surgical procedure, followed by gastric banding (GB) and sleeve gastrectomy (SG) (respectively, 133 (41.0%) RYGB, 97 (30.0%) GB and 58 (18.0%) SG). Seven cases have been reported after OAGB-MGB (3 in gastric remnant, 4 in oesophagus/gastric pouch). Seventy-seven (24%) had distant metastasis (≥ M1/Mx status). The majority of tumours were adenocarcinoma (n = 208, 87.4%). In the majority of the cases, a surgical approach was preferred with either adjuvant chemo or radiotherapy. In the course of the disease, 122 of 324 patients died (37.8%).

Conclusion

To our knowledge, this is the most up-to-date review addressing oesophageal and gastric malignancies after bariatric surgery. Future research should focus to optimise screening for oesophageal and gastric cancer after bariatric surgery.

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Authors and Affiliations

  1. Department of Surgery, Whittington Health NHS Trust, London, UK

    Chetan Parmar

  2. Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, Netherlands

    Sjaak Pouwels

  3. Department of Surgery, Agaplesion Bethanien Hospital, Frankfurt am Main, Hessen, Germany

    Sjaak Pouwels

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  1. Chetan Parmar
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Correspondence to Chetan Parmar.

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Key Points

• This review aims to look at incidence of oesophagogastric (OG) cancer after bariatric surgery (BS).

• This most up-to-date sco** review found 324 cases of OG cancer after BS.

• OG cancer does not seem to be a concern after BS based on this review.

• Future research should focus to optimise screening for oesophageal and gastric cancer after bariatric surgery and its timing.

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Parmar, C., Pouwels, S. Oesophageal and Gastric Cancer After Bariatric Surgery: an Up-to-Date Systematic Sco** Review of Literature of 324 Cases. OBES SURG 32, 3854–3862 (2022). https://doi.org/10.1007/s11695-022-06304-5

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