Increased mortality in prostate carcinoma and smoking-related disease after parietal cell vagotomy: a long-term follow-up study.

Abstract

OBJECTIVE:

There is an increased risk of gastrointestinal carcinoma and smoking-related diseases after partial gastrectomy for peptic ulcer disease. The purpose of this study was to evaluate long-term cancer incidence and mortality after parietal cell vagotomy (PCV), a surgical method with a low rate of side effects, but creating hypochlorhydria in the stomach mimicking long-term treatment with antisecretory drugs.

MATERIAL AND METHODS:

Data on 383 ulcer patients operated on with PCV during 1971-80 at Lund University Hospital were compared with the national registers for cause of death and cancer incidence for selected diagnoses. Median follow-up was 28 years and 31 years, respectively. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated.

RESULTS:

An increased incidence of cancer in the respiratory organs (SIR 1.97, 95% CI: 1.08-3.31) and prostate carcinoma (SIR 1.85, 95% CI: 1.22-2.69) was found, and among men also an increased mortality in prostate carcinoma (SMR 3.85, 95% CI: 1.41-8.38) and chronic respiratory disease (SMR 2.76, 95% CI: 1.01-6.02). Overall mortality was similar to that of the background population and no increased risk of gastrointestinal malignancies was observed.

CONCLUSIONS:

Patients with peptic ulcer operated on with PCV have a long-term increased risk of smoking-related diseases, but PCV does not seem to increase the risk of gastrointestinal carcinoma. An increased risk of, and mortality in prostate carcinoma was found, a cancer previously not found to be related to smoking. This might be the result of surgery-induced hypochlorhydria, which warrants further investigation in patients on long-term proton-pump inhibitors.

• Authors: Kristina Ahsberg, Håkan Olsson, Christer Staël von Holstein
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 44 Issue 8 Pg. 947-51 ( 2009) ISSN: 1502-7708 [Electronic] England
• PMID: 19530033 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Achlorhydria (complications, etiology)
• Adolescent
• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Prostatic Neoplasms (mortality)
• Respiratory Tract Diseases (epidemiology)
• Risk Factors
• Vagotomy, Proximal Gastric (adverse effects)