Bariatric surgery associated with decreased risk of hepatocellular carcinoma: Study

Obesity is a risk factor for non-alcoholic steatohepatitis (NASH) and increases the risk of several cancer types including cancers of the liver. Bariatric surgery can provide durable weight loss, but little is known about the later development of hepatocellular carcinoma (HCC) after surgery.

Obesity is recognized as a significant risk factor for various types of cancer, including HCC. Currently, United States cancer prevention guidelines include recommendations for weight loss; however, it remains unclear whether intentional weight reduction truly reduces cancer risk. While dietary modification and exercise are the first-line treatments available to promote weight loss in the general population, these approaches are generally unsuccessful in achieving ideal weight loss targets and sustained weight loss over time. At present, bariatric surgery provides the highest level of weight loss and improvement in weight-related comorbidities as compared to other available methods of weight reduction.

With the aim to determine whether bariatric surgery reduces the risk of HCC,a team of researchers under Daryl Ramai, from the Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY,sought out this recent study.

For the study design,researchers performed a comprehensive literature search of major databases (from inception to November 2020) to identify studies which assess the incidence and risk of HCC following bariatric surgery. Pooled data were assessed using a random-effects model expressed in terms of odds ratio (OR), incidence rate ratio and 95% confidence interval (CI).

Results highlighted some interesting facts.

• Nine studies (two abstracts and seven full texts) were included for meta-analysis which involved 19 514 750 patients (18 423 546 controls and 1 091 204 bariatric patients).
• Pooled unadjusted odds ratio (OR) was 0.40 (95% CI: 0.28-0.57) which favoured bariatric surgery, though with high heterogeneity (I2: 79%).
• Using an adjusted model derived from matched cohorts (five studies) yielded an OR of 0.63 (95% CI: 0.53-0.75) with moderate heterogeneity (I2: 38%).
• The pooled rate/1000 person-years was 0.05 (95% CI: 0.02-0.07) in bariatric surgery patients and 0.34 (95% CI: 0.20-0.49) in the control group with an incidence rate ratio of 0.28 (95% CI: 0.18-0.42).

For full article follow the link: https://doi.org/10.1111/apt.16335

Primary source: Alimentary Pharmacology & Therapeutics