Division of Colorectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan.
Division of Urology, Department of Surgery, E-Da Cancer & E-Da Hospital, Kaohsiung, Taiwan.
Obes Surg. 2021 Sep;31(9):4015-4023. doi: 10.1007/s11695-021-05511-w. Epub 2021 Jun 5.
This study assessed the benefits and efficacy of bariatric surgery (BS) in reducing the risk of cancer in Asians with morbid obesity.
Records for patients aged between 18 and 55 years whose diagnoses corresponded with the ICD-9 codes for obesity and BS were extracted from the National Health Insurance Research Database (NHIRD) in Taiwan between 2000 and 2015. The patients who underwent BS (BS group), those who did not undergo BS (NS group), and the general population (GP group) were propensity score matched. The outcome was newly diagnosed malignancy. Data were extracted from the Registry for Catastrophic Illness Patient Database (RCIPD) of the NHIRD.
The BS group developed significantly less malignancy (1.18%) than the GP group (1.46%, p = 0.0364). There was no statistically significant difference in malignancy risk between the BS and GP groups (aHR =1.00, p = 0.9997). The NS group developed significantly higher malignancy (2.48%) than the GP group (1.97%, p < 0.0001). There was a significantly higher malignancy risk in the NS group (aHR =1.22, p < 0.0001) than in the GP group. In the subgroup analysis, the malignancy risks of the NS group were significantly higher in the subgroup of men aged between 18 and 35 years (aHR =1.37, p = 0.003) and women aged between 18 and 35 years (aHR = 1.62, p < 0.0001), and 35-55 years (aHR = 1.27, p < 0.0001). All the subgroup analyses between the BS and GP groups demonstrated no significant differences.
Our study demonstrated that BS reduced the risk of malignancy in patients with morbid obesity, particularly in women and young men.
本研究评估了减重手术（BS）在降低亚洲病态肥胖患者癌症风险方面的益处和疗效。
从台湾全民健康保险研究数据库（NHIRD）中提取了 2000 年至 2015 年间年龄在 18 至 55 岁之间、ICD-9 编码诊断为肥胖和 BS 的患者记录。对接受 BS（BS 组）、未接受 BS（NS 组）和普通人群（GP 组）的患者进行倾向评分匹配。结局为新发恶性肿瘤。数据从 NHIRD 的灾难性疾病患者登记数据库（RCIPD）中提取。
BS 组的恶性肿瘤发生率（1.18%）明显低于 GP 组（1.46%，p=0.0364）。BS 组和 GP 组之间的恶性肿瘤风险无统计学差异（aHR=1.00，p=0.9997）。NS 组的恶性肿瘤发生率（2.48%）明显高于 GP 组（1.97%，p<0.0001）。NS 组的恶性肿瘤风险明显高于 GP 组（aHR=1.22，p<0.0001）。在亚组分析中，NS 组男性 18-35 岁（aHR=1.37，p=0.003）和女性 18-35 岁（aHR=1.62，p<0.0001）和 35-55 岁（aHR=1.27，p<0.0001）亚组的恶性肿瘤风险明显更高。BS 组和 GP 组之间的所有亚组分析均无显著差异。
本研究表明，BS 降低了病态肥胖患者发生恶性肿瘤的风险，尤其是女性和年轻男性。
