IBC Oxford University Oral Abstract 22 - Esophagogastric cancer surgery characteristics and outcomes in bariatric patients, compared with non-bariatric patients

Abstract Background The association between bariatric surgery and esophagogastric cancer (EGC) is debated. This study aimed to assess EGC characteristics and surgery outcomes comparing bariatric and non-bariatric patients. Methods Single-centre retrospective analysis of prospective EGC surgery database. Results EGC-surgery was performed in 269 patients, classified as bariatric (n = 10, 3.3%), and non-bariatric (n = 259, 96.6%) groups. Non-bariatric group was sub-classified into body mass index (BMI) <35 kg/m2 (n = 244) and >35 kg/m2 (n = 15). BMI was 35.3 ± 5.6 versus 25.7 ± 16.1 and 37.8 ± 8.7 kg/m2 in bariatric versus non-bariatric-BMI <35 and >35, respectively (P < 0.001). Bariatric patients were significantly younger (56.75 ± 11 versus 71 ± 10 and 68.38 ± 8.2 years; P < 0.001). They tended to have lower rates of diabetes mellitus (30% versus 43.9% and 73.3%; P = 0.05) and significantly lower hypertension rates (50%, versus 86.5% and 93.3%, P < 0.004). Bariatric procedures were performed 11.3 years (IQR 5.5–16.5) prior to EGC-surgery. Tumour characteristics were statistically comparable except a significantly higher number of positive LN in the bariatric group (6.9 ± 13.6 versus 2.7 ± 4.9 and 1.9 ± 4.8;P = 0.006), and more bariatric patients received adjuvant treatment (P = 0.035). Postoperative major complication rates (0% versus 25.8%, and 33.3%; P = 0.14) and length of hospital stay (14.1 ± 15.3, versus 23 ± 28.5, and 21 ± 18 days; P = 0.59) were comparable. There was no significant difference in Disease- free survival (P = 0.42) or overall survival (P = 0.48) between patient-groups. Conclusions Bariatric patients were diagnosed with EGC at a younger age and tended to have worse nodal involvement. Although outcomes were comparable, clinical and endoscopic surveillance seem important as EGC can occur 10 years or earlier than in non-bariatric patients.