S1454 Association of Body Mass Index in Patients After Bariatric Surgery With the Onset of Pancreatic Cancer: A Nationwide Inpatient Sample Database Analysis

Abstract

Introduction: Obesity (Body Mass Index [BMI] >= 30) has been associated with a 3.5-fold increased risk of cancer. Higher BMI has led to increased cancer-related mortality and chemotherapy resistance. Prior studies have demonstrated a protective effect of weight loss in certain cancers such as endometrial, breast, and pancreatic. However, the literature behind weight loss and the protective effect on pancreatic cancer remains controversial. In this study, we evaluate the relationship between different BMI ranges in patients who underwent bariatric surgery and the onset of pancreatic cancer. Methods: The National Inpatient Sample (NIS) database was used to identify hospitalized patients over 18 years old who had bariatric surgery between 2012 to 2017 using ICD9 and ICD10 codes. Patients were divided into a cancer and non-cancer group. Those with pancreatic cancer were identified and were matched by age, race, and gender. Primary outcomes were associations between BMI ranges in patients who underwent bariatric surgery and pancreatic cancer. Multivariate analyses were performed to assess outcomes. Results: From 2012 to 2017, there was a total of 1,695,860 patients who had bariatric surgery. Of these patients, 4,225 patients had pancreatic cancer. The mean age was 60 years old, 27.3% were male, and 79.2% were White. The results were significant (P< 0.001) for decreased risk of cancer in patients who underwent bariatric surgery and had BMI 40-49.9 (OR 0.46) and BMI >=50 (OR 0.31) (Table). Conclusion: Weight loss through bariatric surgery has been shown to reduce the risks of various cancers. This is likely due to the reduction in adipose tissue regulated chemokine signaling involved in oncogenesis. Our data suggests that patients with higher stages of obesity (BMI >=40) who underwent bariatric surgery would benefit the most by risk reduction from pancreatic cancer. These findings could be a platform for future prospective studies to investigate risk reduction strategies in pancreatic cancer, which still is the 3rd leading cause of cancer-related deaths. Table 1. - Association between Body Mass Index in Patients with Bariatric Surgery and the Onset of Pancreatic Cancer Odds Ratio (95% CI) P-Value BMI 30-34.9 0.96 (0.80-1.15) 0.645 BMI 35-39.9 1.02 (0.85-1.23) 0.814 BMI 40-49.9 0.46 (0.39-0.55) < 0.001 BMI >=50 0.31 (0.23-0.44) < 0.001 CI = Confidence Interval