Loyola University Medical Center; Mercy Hospital and Medical Center Chicago, IL
Mohamad A. Minhem, MD1, Rami E. Lutfi, MD2; 1Loyola University Medical Center; Mercy Hospital and Medical Center, Chicago, IL; 2Mercy Hospital and Medical Center, Chicago, IL
Introduction: The impact of morbid obesity and weight loss surgery (WLS) on GI malignancy remains uncertain. We aimed to investigate if obesity and WLS could alter the risk of GI tumors (GITs). Methods: The study aims to investigate the cross-sectional relationship between prior WLS and GITs. Data were obtained from 2016 National Inpatient Sample (NIS) database. Multivariate analyses were performed to study primary outcome, the incidence of GITs. Results: Patients with GITs were less morbidly obese (MO) (6.1% vs. 10.7%), more cachectic (3.9% vs. 0.8%) and malnourished (18.1% vs. 4.7%) compared to patients without GITs. Given that multiple factors that can affect weight loss in cancer patients, we selected MO patients with BMI≥35Kg/m2. Out of 622,834 MO patients, 19,932 (3.1%) had undergone WLS. Patients who underwent WLS were older (55.3 vs. 53.8 years, p< 0.01), more females (74.4% vs. 64.5%, p< 0.01), and more White (72.0% vs. 66.9%, p< 0.01). The incidence of tumors among MO patients was 0.4% for colon, 0.1% for rectum, 0.1% for gastric, and < 0.1% for esophageal and small bowel tumors. Based on multivariate analysis; esophageal, gastric, small bowel, and colon tumors had no statistically significant association with a prior history of WLS. Only rectal cancer was associated with reduced incidence following WLS (adjusted OR= 0.31[0.15,0.61], p< 0.01]). Discussion: In MO patients, WLS may be associated with a reduced incidence of rectal cancer. This study does not show any association with other types of GITs. Future prospective studies should clarify the multifactorial relationship between WLS and the development of GITs.
Disclosures: Mohamad Minhem indicated no relevant financial relationships. Rami Lutfi: Gore – Consultant, Educational Grant. Olympus – Consultant.