Cardiometabolic outcomes after bariatric surgery in adult survivors of childhood cancer: a SJLIFE report

J Natl Cancer Inst. 2025 Jun 20:djaf151. doi: 10.1093/jnci/djaf151. Online ahead of print.

Abstract

Childhood cancer survivors are at increased risk for obesity which can potentiate treatment-related late-effects. The association between bariatric surgery and cardiometabolic outcomes in survivors is unknown. Survivors of childhood cancer enrolled in the St Jude Lifetime Cohort with prior bariatric surgery for obesity (n = 33) and survivors with severe obesity without prior bariatric surgery (n = 542) were included. Body mass index (BMI) change was described. Multivariable logistic regression compared prevalence of cardiometabolic outcomes at follow-up. Mean change in BMI was -11.8 kg/m2±8.7 (standard deviation) and +0.7 kg/m2±4.2 among survivors with and without bariatric surgery, after median follow-up of 6.1 and 5.3 years, respectively. Survivors with bariatric surgery, compared to those without, had lower odds of dyslipidemia (odds ratio (OR): 0.3, 95% confidence interval (CI): 0.1-0.8) and prediabetes (OR: 0.4, 95%CI: 0.2-0.8). Bariatric surgery is associated with sustained BMI reduction and lower risk for cardiometabolic conditions in survivors of childhood cancer.