Reflux Surgery Won't Guard Against Cancer

Thu, 01/28/2010 - 12:41pm

(Reuters) Patients who have surgery to treat severe heartburn, or gastroesophageal reflux disease (GERD), continue to have a very high risk of developing cancer of the esophagus even after 15 years or more, a new study has found.

“This study should put to rest the notion that antireflux surgery prevents esophageal cancer. It was always a viewpoint based more on hope than data but, now that the data are in, the conclusions should be accepted,” said Dr. Peter J. Kahrilas, professor of medicine at Northwestern University's Feinberg School of Medicine in Chicago.

The researcher who headed the study, Dr. Jesper Lagergren, professor of surgery at the Karolinska Institute in Stockholm, stated, “We expected a decreased risk of cancer with increased time after surgery, but we didn't find it. There is no evidence to support the idea that antireflux surgery prevents cancer development of the esophagus.”

Although GERD can be controlled through lifestyle changes and medication, some patients require surgery to reinforce the valve between the esophagus and stomach. Antireflux surgery has been shown to provide long-term improvement. Why doesn't antireflux surgery protect against cancer? Possible reasons include the continuation of reflux after surgery, the length of time patients had reflux prior to surgery, and its severity, Lagergren said.

To investigate the causes, he and his colleagues are delving deeper into the data. “We are evaluating the surgery itself as well as other risk factors, for example obesity, surgeon experience, and the recurrence of reflux,” he said.

SOURCE: Gastroenterology


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