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Bariatric surgery reduces the risk of pancreatic cancer in individuals with obesity before the age of 50 years: A nationwide administrative data study in France

  • Julie Bulsei
    Affiliations
    Centre Hospitalier Universitaire de Nice, Department of Clinical Research and Innovation, Université Côte d'Azur, Nice, France
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  • Andrea Chierici
    Affiliations
    Service de Chirurgie Digestive, Centre Hospitalier d’Antibes Juan-les-Pins, 107, av. de Nice, 06600, Antibes, France
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  • Marco Alifano
    Affiliations
    Thoracic Surgery Department, Cochin Hospital, APHP Centre, University of Paris, France

    INSERM U1138 Team «Cancer, Immune Control, and Escape», Cordeliers Research Center, University of Paris, France
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  • Antonio Castaldi
    Affiliations
    Centre Hospitalier Universitaire de Nice - Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France
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  • Céline Drai
    Affiliations
    Centre Hospitalier Universitaire de Nice - Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France

    Université Côte d’Azur, Nice, France
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  • Serena De Fatico
    Affiliations
    Centre Hospitalier Universitaire de Nice - Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France
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  • Edoardo Rosso
    Affiliations
    Unité des Maladies de l'Appareil Digestif et Endocrine, Department of Surgery and Robotics, Centre Hospitalier de Luxembourg, L-1210 Luxembourg, Luxembourg
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  • Eric Fontas
    Affiliations
    Centre Hospitalier Universitaire de Nice, Department of Clinical Research and Innovation, Université Côte d'Azur, Nice, France
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  • Antonio Iannelli
    Correspondence
    Corresponding author. Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, 151 Route Saint Antoine de Ginestière, BP 3079, Nice Cedex 3, France.
    Affiliations
    Centre Hospitalier Universitaire de Nice - Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France

    Université Côte d’Azur, Nice, France

    Inserm, U1065, Team 8 “Hepatic complications of obesity and alcohol”, France
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Published:November 08, 2022DOI:https://doi.org/10.1016/j.ejso.2022.11.013

      Abstract

      Background

      Obesity is a well-established risk factor for pancreatic cancer. Bariatric surgery has demonstrated superior results in terms of weight loss and obesity-related comorbidities compared to medical and behavioral treatments. The aim of this study is to evaluate the effect of bariatric surgery on pancreatic cancer incidence in individuals with obesity.

      Method

      Individuals with a diagnosis of obesity were retrieved from the French national hospital discharge database. We conducted a cohort study comparing the risk to develop pancreatic cancer in individuals with obesity with and without history of bariatric surgery; the inverse probability of treatment weighting (IPTW) method was performed to assess the uncertainty around the results. Moreover, a subgroup analysis according to age at the time of bariatric surgery was performed to study its impact on the risk of pancreatic cancer. Finally, possible differences depending on the type of bariatric procedure (sleeve gastrectomy vs Roux-en-Y gastric bypass) were also explored.

      Results

      160,129 (Bariatric Surgery group) and 1,263,804 (control group) patients with 5.2 ± 1.9 and 6.0 ± 1.9 years of follow-up respectively were included. A significant reduced risk to develop pancreatic cancer during follow-up was identified for the bariatric surgery group in the overall population (HR: 0.567). However, this reduced risk was only observed in the 18–50 years group. These results were furtherly confirmed after IPTW analysis. No difference was found between different bariatric procedures.

      Conclusion

      Bariatric surgery has a protective effect against pancreatic cancer in the 18–50 years population. High-quality prospective studies are needed to confirm these results.

      Keywords

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