COMMENTARY

Does Antireflux Surgery Prevent the Development of Esophageal Cancer?

David A. Johnson, MD

Disclosures

April 26, 2010

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Citation: Lagergren J, Ye W, Lagergren P, et al. The risk of esophageal adenocarcinoma after antireflux surgery. Gastroenterology. 2010;138:1297-1301.

Babar M, Ennis D, Abdel-Latif M, et al. Differential molecular changes in patients with asymptomatic long-segment Barrett's esophagus treated by antireflux surgery or medical therapy. Am J Surg. 2010;199:137-143.

Ye W, Chow WH, Lagergren J, et al. Risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux diseases and after antireflux surgery. Gastroenterology. 2001;121:1286-1293.

Tran T, Spechler SJ, Richardson P, et al. Fundoplication and the risk of esophageal cancer in gastroesophageal reflux disease: a Veterans Affairs cohort study. Am J Gastroenterol. 2008;100:1002-1008.

Gastroesophageal reflux disease (GERD) is clearly established as a risk factor for the development of esophageal adenocarcinoma. Given the poor prognosis of this disease, preventative strategies, if identified, are clearly warranted. Surgical fundoplication has been heralded (particularly by surgeons) as a definitive antireflux intervention with esophageal cancer preventative benefits. This retrospective population-based analysis from Sweden evaluated data from 1965 to 2006, with essentially complete capture of all data for 14,102 patients and 120,514 person-years at risk. Is antireflux surgery a benefit for cancer prevention or is this a myth?

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