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 23 November 2017

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News

Fundoplication and esophageal cancer risk in GERD

GERD is a risk factor for esophageal cancer, but there is insufficient evidence that fundoplication reduces that risk, finds the most recent issue of American Journal Gastroenterology.

News image

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It has been proposed that fundoplication can reduce the risk of esophageal cancer in patients with gastroesophageal reflux disease.

Dr El-Serag and colleagues from Houston conducted a cohort study, and assessed the effect of fundoplication on the incidence of esophageal cancer.

The investigative team identified all Veterans Affairs patients with GERD who had fundoplication between 1986 and 1990.

The patients were matched to controls with GERD and no fundoplication and to controls with no GERD.

The team calculated incidence rates for esophageal cancer through October 2002 and examined the effect of fundoplication on the risk of esophageal cancer.

The researchers used the Kaplan-Meier survival analysis and Cox proportional hazard analysis and adjusted for the propensity score for receiving fundoplication.

After 20,115 follow-up patient years, there were 8 cases of esophageal cancer in the GERD without fundoplication group
American Journal Gastroenterology

The investigators identified 946 patients who had fundoplication, 1892 patients who had GERD without fundoplication, and 5676 patients with no GERD.

The research team reported that the mean age was 55 years and that 98% were men in all 3 groups.

During a follow-up of 11,156 patient-years, there were 8 cases of esophageal cancer in the fundoplication group.

The researchers observed that during a follow-up of 20,115 patient years, there were 8 cases of esophageal cancer in the GERD without fundoplication group.

During a follow-up of 59,439 patient-years, no patients in the group with no GERD developed esophageal cancer.

The research team noted that the Kaplan-Meier analysis showed no significant difference in cumulative esophageal cancer rates between the fundoplication group and the GERD no-fundoplication group.

The adjusted hazard ratio of esophageal cancer with fundoplication was 1.88.

Dr El-Serag, concludes, "GERD is a risk factor for esophageal cancer, but there is insufficient evidence that fundoplication reduces that risk."

Am J Gastroenterol 2005: 100(5): 1002
22 April 2005

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