Obesity Surgery and Cancer: What Are the Unanswered Questions?

Castagneto-Gissey, Lidia; Casella-Mariolo, James; Casella, Giovanni; Mingrone, Geltrude

doi:10.3389/fendo.2020.00213

Cited by 35 publications

(31 citation statements)

References 76 publications

(119 reference statements)

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“…Bariatric surgery is the most effective treatment for obesity and its associated metabolic and cardiovascular complications. On the whole studies report that overall cancer incidence and mortality is reduced post bariatric surgery, particularly in women [ 252 , 253 , 254 ]. Obesity is responsible for increased estradiol production in adipose tissue thus driving hormone sensitive cancers and the augmented concentration of total serum estrogen following bariatric surgery is suggested to be the reason for reduced post-menopausal breast and endometrial cancer risk [ 254 ].…”

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

“…On the whole studies report that overall cancer incidence and mortality is reduced post bariatric surgery, particularly in women [ 252 , 253 , 254 ]. Obesity is responsible for increased estradiol production in adipose tissue thus driving hormone sensitive cancers and the augmented concentration of total serum estrogen following bariatric surgery is suggested to be the reason for reduced post-menopausal breast and endometrial cancer risk [ 254 ]. Indeed bariatric surgery may also reduce tumor progression by specifically treating hyperinsulinemia and reducing high circulating IGF-1 levels [ 254 ].…”

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

“…Obesity is responsible for increased estradiol production in adipose tissue thus driving hormone sensitive cancers and the augmented concentration of total serum estrogen following bariatric surgery is suggested to be the reason for reduced post-menopausal breast and endometrial cancer risk [ 254 ]. Indeed bariatric surgery may also reduce tumor progression by specifically treating hyperinsulinemia and reducing high circulating IGF-1 levels [ 254 ]. However, data is conflicting and there is a potential increase in cancer incidence following bariatric surgery [ 254 , 255 ].…”

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

“…Indeed bariatric surgery may also reduce tumor progression by specifically treating hyperinsulinemia and reducing high circulating IGF-1 levels [ 254 ]. However, data is conflicting and there is a potential increase in cancer incidence following bariatric surgery [ 254 , 255 ]. There are reports suggesting bariatric surgery results in an increased risk of colorectal cancer (CRC) but the results are complicated as control groups were not standardized for weight changes, dietary changes and medications, which can have a profound impact on CRC incidence [ 255 ].…”

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

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Obesity and Cancer Metastasis: Molecular and Translational Perspectives

Annett

Moore

Robson

2020

Cancers

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Obesity is a modern health problem that has reached pandemic proportions. It is an established risk factor for carcinogenesis, however, evidence for the contribution of adipose tissue to the metastatic behavior of tumors is also mounting. Over 90% of cancer mortality is attributed to metastasis and metastatic tumor cells must communicate with their microenvironment for survival. Many of the characteristics observed in obese adipose tissue strongly mirror the tumor microenvironment. Thus in the case of prostate, pancreatic and breast cancer and esophageal adenocarcinoma, which are all located in close anatomical proximity to an adipose tissue depot, the adjacent fat provides an ideal microenvironment to enhance tumor growth, progression and metastasis. Adipocytes provide adipokines, fatty acids and other soluble factors to tumor cells whilst immune cells infiltrate the tumor microenvironment. In addition, there are emerging studies on the role of the extracellular vesicles secreted from adipose tissue, and the extracellular matrix itself, as drivers of obesity-induced metastasis. In the present review, we discuss the major mechanisms responsible for the obesity–metastatic link. Furthermore, understanding these complex mechanisms will provide novel therapies to halt the tumor–adipose tissue crosstalk with the ultimate aim of inhibiting tumor progression and metastatic growth.

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Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

Section: Targeting Metastasis Via the Treatment Of Obesitymentioning

confidence: 99%

See 2 more Smart Citations

Obesity and Cancer Metastasis: Molecular and Translational Perspectives

Annett

Moore

Robson

2020

Cancers

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“…Greater clarity is needed to define the role of antiobesity or antidiabetes medications as potential cancer risk reduction strategies. Lastly, the observational data supporting the anticancer potential of metabolic surgery should continue to be investigated (100).…”

Section: Pressing Questions To Advance the Fieldmentioning

confidence: 99%

The Triple Health Threat of Diabetes, Obesity, and Cancer—Epidemiology, Disparities, Mechanisms, and Interventions

Brown

Carson

Thompson

et al. 2021

Obesity

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Obesity and type 2 diabetes are both chronic, relapsing, progressive diseases that are recognized as risk factors for the development of multiple types of cancer. In a recent symposium titled “Hitting A Triple—Diabetes, Obesity, and the Emerging Links to Cancer Risk,” convened by The Obesity Society during ObesityWeek 2019, experts in the field presented the current science and highlighted existing research gaps. Topics included (1) the epidemiology of obesity and diabetes and their links to cancer risk; (2) racial and ethnic differences in obesity, diabetes, and cancer risk; (3) biological mechanisms common to obesity and diabetes that may increase cancer risk; and (4) innovative interventions that can be used to prevent the development of cancers related to obesity and diabetes. This report provides an overview of the symposium and describes key research gaps and pressing questions in need of answers to advance the field. The collective burden of obesity, diabetes, and cancer represents one of the largest public health challenges of the century. Although the symposium was titled “hitting a triple,” it was recognized that being able to disrupt the linkages among obesity, diabetes, and cancer would be a “grand slam” for public health and medicine.

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Risk of Esophageal and Gastric Cancer After Bariatric Surgery

et al. 2023

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ImportanceBariatric surgery has been associated with a reduced risk of cancer in individuals with obesity. The association of bariatric surgery with esophageal and gastric cancer is still controversial, however.ObjectiveTo compare the incidence of esophageal and gastric cancer between patients with obesity who underwent bariatric surgery and those who did not (control group).Design, Setting, and ParticipantsThis cohort study obtained data from a national discharge database, including all surgical centers, in France from January 1, 2010, to December 31, 2017. Participants included adults (aged ≥18 years) with severe obesity who underwent bariatric surgery (surgical group) or who did not (control group). Baseline characteristics were balanced between groups using nearest neighbor propensity score matching with a 1:2 ratio. The study was conducted from March 1, 2020, to June 30, 2021.ExposuresBariatric surgery (adjustable gastric banding, gastric bypass, and sleeve gastrectomy) vs no surgery.Main Outcomes and MeasuresThe main outcome was incidence of esophageal and gastric cancer. A secondary outcome was overall in-hospital mortality.ResultsA total of 303 709 patients who underwent bariatric surgery (245 819 females [80.9%]; mean [SD] age, 40.2 [11.9] years) were matched 1:2 with 605 140 patients who did not receive surgery (500 929 females [82.8%]; mean [SD] age, 40.4 [12.5] years). After matching, the 2 groups of patients were comparable in terms of age, sex, and comorbidities (standardized mean difference [SD], 0.05 [0.11]), with some differences in body mass index. The mean follow-up time was 5.62 (2.20) years in the control group and 6.06 (2.31) years in the surgical group. A total of 337 patients had esophagogastric cancer: 83 in the surgical group and 254 in the control group. The incidence rates were 6.9 per 100 000 population per year for the control group and 4.9 per 100 000 population per year for the surgical group, resulting in an incidence rate ratio of 1.42 (95% CI, 1.11-1.82; P = .005). The hazard ratio (HR) of cancer incidence was significantly in favor of the surgical group (HR, 0.76; 95% CI, 0.59-0.98; P = .03). Overall mortality was significantly lower in the surgical group (HR, 0.60; 95% CI, 0.56-0.64; P &lt; .001).Conclusions and RelevanceIn this large, nationwide cohort of patients with severe obesity, bariatric surgery was associated with a significant reduction of esophageal and gastric cancer incidence and overall in-hospital mortality, which suggests that bariatric surgery can be performed as treatment for severe obesity without increasing the risk of esophageal and gastric cancer.

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Obesity Surgery and Cancer: What Are the Unanswered Questions?

Cited by 35 publications

References 76 publications

Obesity and Cancer Metastasis: Molecular and Translational Perspectives

Obesity and Cancer Metastasis: Molecular and Translational Perspectives

The Triple Health Threat of Diabetes, Obesity, and Cancer—Epidemiology, Disparities, Mechanisms, and Interventions

Risk of Esophageal and Gastric Cancer After Bariatric Surgery

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