Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California.
Surg Obes Relat Dis. 2022 Jan;18(1):42-52. doi: 10.1016/j.soard.2021.09.017. Epub 2021 Sep 28.
The number of bariatric surgeries performed in the United States has increased substantially since the 1990's. However, the prevalence and prognostic impact of bariatric surgery, or weight loss surgery (WLS), among patients with cancer are not known.
We investigated the population-based prevalence of WLS in women with breast or endometrial cancer and conducted exploratory analysis to examine whether postdiagnosis WLS is associated with survival.
Administrative statewide database.
WLS records for women with nonmetastasized breast (n = 395,146) or endometrial (n = 69,859) cancer were identified from the 1991-2014 California Cancer Registry data linked with the California Office of Statewide Health Planning and Development database. Characteristics of the patients were examined according to history of WLS. Using body mass index data available since 2011, a retrospective cohort of patients with breast or endometrial cancer and obesity (n = 12,540) was established and followed until 2017 (5% lost to follow-up). Multivariable cause-specific Cox proportional hazards models were used to examine the associations between postdiagnostic WLS and time to death.
WLS records were identified for 2844 (.7%) patients with breast cancer and 1140 (1.6%) patients with endometrial cancer; about half of the surgeries were performed after cancer diagnosis. Postdiagnosis WLS was performed in ∼1% of patients with obesity and was associated with a decreased hazard for death (cause-specific hazard ratio = .37; 95% confidence interval = .014-.99; P = .049), adjusting for age, stage, co-morbidity, race/ethnicity, and socioeconomic status.
About 2000 patients with breast or endometrial cancer in California underwent post-diagnosis WLS between 1991 and 2014. Our data support survival benefits of WLS after breast and endometrial cancer diagnosis.
自 20 世纪 90 年代以来，美国进行的减肥手术（WLS）数量大幅增加。然而，癌症患者接受减肥手术或减重手术（WLS）的流行程度和预后影响尚不清楚。
我们调查了加利福尼亚州乳腺癌或子宫内膜癌女性中 WLS 的人群患病率，并进行了探索性分析，以研究诊断后 WLS 是否与生存相关。
行政全州数据库。
从 1991 年至 2014 年加利福尼亚癌症登记处的数据中确定了非转移性乳腺癌（n = 395146）或子宫内膜癌（n = 69859）女性的 WLS 记录，并与加利福尼亚州全州卫生规划和发展办公室数据库相链接。根据 WLS 史检查患者的特征。利用自 2011 年以来可用的体重指数数据，建立了一个患有乳腺癌或子宫内膜癌和肥胖症的回顾性队列（n = 12540），并随访至 2017 年（5%的患者失访）。使用多变量特定原因 Cox 比例风险模型检查诊断后 WLS 与死亡时间之间的关联。
确定了 2844 例（0.7%）乳腺癌患者和 1140 例（1.6%）子宫内膜癌患者的 WLS 记录；约一半的手术是在癌症诊断后进行的。肥胖症患者中约有 1%接受了诊断后 WLS，与死亡风险降低相关（特定原因的风险比=0.37；95%置信区间为 0.014-0.99；P = 0.049），调整了年龄、分期、合并症、种族/族裔和社会经济地位。
在加利福尼亚州，约有 2000 名乳腺癌或子宫内膜癌患者在 1991 年至 2014 年期间接受了诊断后的 WLS。我们的数据支持乳腺癌和子宫内膜癌诊断后 WLS 的生存获益。
