Malignancy in bariatric surgery patients: a French multisite cohort
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Malignancy in bariatric surgery patients: a French multisite cohort Hadrien Tranchart1,2 · Martin Gaillard1,2,13 · Radwan Kassir3 · Caroline Gronnier4,5 · David Moszkowicz6,7 · Imed Ben Amor8,9 · Panagiotis Lainas1,2 · Natalia Savala8,9 · Hugo Meunier10,11 · Yannick Le Roux10,11 · Olivier Degrandi4,5 · Clément Baratte2,12 · Karina Vychnevskaia2,12 · Jean Gugenheim8,9 · Ibrahim Dagher1,2 Received: 23 June 2020 / Accepted: 3 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Obesity · Morbid · Bariatric surgery · Neoplasms · Cohort studies · Weight loss
Hadrien Tranchart and Martin Gaillard are first co-authors. * Martin Gaillard [email protected] 1
Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, 92140 Clamart, France
2
Paris-Saclay University, 91405 Orsay, France
3
Department of Digestive Surgery, Félix Guyon University Hospital, Saint‑Denis, 97400 La Réunion, France
4
Digestive Surgery Department, Bordeaux University Hospital, 33604 Pessac, France
5
Bordeaux University, 33076 Bordeaux, France
6
Department of General and Digestive Surgery, Louis Mourier Hospital, AP-HP, 92700 Colombes, France
7
Paris University, 75006 Paris,
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