Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Surg Obes Relat Dis. 2022 Jan;18(1):102-106. doi: 10.1016/j.soard.2021.08.012. Epub 2021 Aug 26.
The incidence of obesity has been steadily increasing, especially in developed countries. Also, obesity is considered one of the modifiable risk factors of kidney cancer.
This study aims to determine the impact of bariatric surgery-induced weight loss on the prevention of kidney cancer.
Academic Hospital, United States.
The National (Nationwide) Inpatient Sample (NIS) was queried for the period 2010 to 2015 for first-time kidney cancer-related hospitalization, used as a proxy for cancer incidence, in patients with a history of bariatric surgery (cases) and patients with obesity but no history of bariatric surgery (controls). Patients with a previous diagnosis of cancer were excluded from the analysis. In order to identify comparable patients, all controls had to have a body mass index ≥35 kg/m, as per the existing qualification criteria for bariatric surgery. The International Classification of Diseases-9 codes (ICD-9) was used to identify admissions for kidney cancer. A univariate analysis was conducted to compare demographics and co-morbidities between groups. A multivariate logistic regression model was performed to assess differences between surgical and control groups and adjust for independent variables such as smoking history and family history of malignancy. All percentages and means (with confidence intervals [CIs]) were weighted.
A total of 2,300,845 were included in the analysis, of which 2,004,804 controls-subjects, with a mean age of 54.4 ± .05 years, and 296,041 treatment-subjects, with a mean age of 51.9 ± .05 years. Demographics and co-morbidities, such as tobacco use, diabetes, and hypertension, were also measured. Patients with a history of bariatric surgery were significantly less likely to experience renal cancer than patients without a history of bariatric surgery, with 5935 cases in the control group and 684 in the case group (P < .0001). After a multivariate logistic regression was performed, the OR was 1.10 (95% CI: 1.02-1.22, P < .0224).
Our finding suggests that bariatric surgery-induced weight loss could significantly prevent first-time kidney cancer-related hospitalizations in patients with obesity. Prospective studies are needed to confirm our findings.
肥胖的发病率一直在稳步上升，尤其是在发达国家。此外，肥胖被认为是肾癌的可改变的危险因素之一。
本研究旨在确定减重手术引起的体重减轻对预防肾癌的影响。
美国学术医院。
2010 年至 2015 年，国家（全国）住院患者样本（NIS）查询了首次与肾癌相关的住院患者，这些患者是肥胖症患者，曾接受过减重手术（病例），或肥胖但无减重手术史（对照组），作为癌症发病率的替代指标。排除有癌症既往诊断的患者。为了识别可比的患者，所有对照组的体重指数（BMI）必须≥35kg/m2，这是减重手术的现有资格标准。国际疾病分类第 9 版（ICD-9）代码用于识别肾癌的住院情况。进行单变量分析以比较两组之间的人口统计学和合并症。进行多变量逻辑回归模型以评估手术组和对照组之间的差异，并调整吸烟史和恶性肿瘤家族史等独立变量。所有百分比和平均值（置信区间[CI]）均为加权值。
共纳入 2300845 例患者，其中 2004804 例为对照组（平均年龄 54.4±0.05 岁），296041 例为治疗组（平均年龄 51.9±0.05 岁）。还测量了人口统计学和合并症，如吸烟、糖尿病和高血压。与没有减重手术史的患者相比，有减重手术史的患者发生肾癌的可能性显著降低，对照组有 5935 例病例，治疗组有 684 例（P<0.0001）。进行多变量逻辑回归后，比值比（OR）为 1.10（95%CI：1.02-1.22，P<0.0224）。
我们的研究结果表明，减重手术引起的体重减轻可能显著预防肥胖患者的首次肾癌相关住院治疗。需要进行前瞻性研究来证实我们的发现。
