Esophagogastric Cancer After Sleeve Gastrectomy: A Systematic Review of Case Reports

Introduction: Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. It has been shown that bariatric surgery reduces cancer risk. However, the risk of esophagogastric cancer after SG has not been defined yet and the development of cancer in the esophagus and stomach remains a matter of concern. Methods: Web of Science, PubMed and Embase databases were searched. Articles that described the diagnosis and management of esophageal or gastric cancer after SG were considered. Results: Seventeen esophagogastric cancer patients after SG were included. The age of the patients ranged from 21 to 64 years. Tumors were diagnosed after an interval of 33.9 +/- 22.8 months from SG (range 4 months-96 months). There were 4 esophageal cancers,4 gastroesophageal cancers and 9 gastric cancers; adenocarcinoma was the most frequent tumor histology (88.2%). The most commonly reported symptoms were food intolerance/dyspepsia (50.0%), vomiting/nausea/regurgitation (35.7%). Upper gastrointestinal endoscopy (UGIE) with biopsy was used for diagnosis in most of the patients. Surgery was performed in 10 patients (58.8%), while 4 patients were treated by endoscopic procedures (23.5%). The mean follow-up length was 12.2 months (range 3 months- 36 months) and the overall disease-free survival rate was 88.9%. Conclusion: The development of esophagogastric cancer after SG is still not well defined but it may occur at any time. Preoperative and follow-up UGIE are essential in order to allow for prevention, early diagnosis. Further epidemiologic studies are needed to investigate the post-SG-related risk of esophagogastric cancer development.