Obesity surgery and malignancy: our experience after 1500 cases

Background: Obesity is a risk factor for cancer and is associated with increased mortality from a number of malignancies. We describe our experience with bariatric surgery,patients with a history of malignancy and review the safety and outcomes of bariatric surgery in patients with a history of cancer. Methods: We performed a retrospective review of prospectively collected data from all patients diagnosed with a malignancy before, during, or after bariatric surgery. Data on weight loss, co-morbidities, and recurrence were collected. Results: From July 1999 to February 2008, 1566 patients underwent bariatric surgery. Of these 1566 patients, 36 (2.3%) had a history of malignancy before they underwent bariatric evaluation and surgery, 4 (0.26%) were diagnosed with a malignancy during their preoperative evaluation, 2 of whom Subsequently underwent bariatric surgery, and 2 had intraoperative findings suspicious for malignancy; bariatric Surgery was completed in both cases. The evaluation revealed renal cell carcinoma and low-grade lymphoma, respectively. No procedures were aborted because of a suspicion of malignancy. Postoperatively, 16 patients (0.9%) were diagnosed with cancer, 3 of whom had a history of malignancy: I with metastatic renal cell, I with recurrent melanoma, and 1, who had had prostate cancer, with bladder cancer. Conclusion: A history of malignancy does not appear to be a contraindication for bariatric surgery as long its the life expectancy is reasonable. Screening for bariatric sur cry might reveal 9 the malignancy. Bariatric surgery does not seem to have a negative effect on the treatment of malignancies that are discovered in the postoperative period. (Surg Obes Relat Dis 2009;5: 160-164.) (C) 2009 American Society for Metabolic and Bariatric Surgery. All rights reserved.