Journal of Obesity & Eating Disorders

Description

Obesity has become a pervasive global health issue, affecting more than 40% of the global population and continuing to rise. Beyond its implications for cardiovascular and metabolic diseases, obesity significantly increases the risk of various cancers, including Primary Liver Cancer (PLC). This type of cancer accounts for a notable proportion of cancer-related deaths globally and poses a significant health challenge due to its association with conditions like metabolic dysfunctionassociated steatohepatitis and liver cirrhosis.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) serves as a precursor to more severe conditions like Metabolic Dysfunction-Associated Steatohepatitis (MASH), characterized by hepatic inflammation, steatosis (accumulation of fat in liver cells), and varying degrees of fibrosis (scarring of liver tissue). These conditions not only worsen liver health but also escalate the risk of developing Hepato Cellular Carcinoma (HCC), the predominant form of primary liver cancer, often arising in the context of chronic liver diseases or cirrhosis. Additionally, Intrahepatic Cholangiocarcinoma (ICC), while rare, presents unique challenges due to its poor prognosis, typically associated with late-stage diagnosis.

Metabolic and Bariatric Surgeries (MBS) have emerged as highly effective interventions for achieving substantial weight loss and alleviating comorbidities in individuals with morbid obesity. Extensive research has consistently demonstrated that weight loss resulting from MBS leads to significant improvements in metabolic syndrome, reduced incidence of MASH, diabetes, cardiovascular risks, and certain types of cancers. Moreover, individuals undergoing MBS have shown enhanced life expectancy compared to those receiving standard obesity care, even after adjusting for cardiovascular and cancerrelated mortality rates, which are the primary causes of death among patients with MASH.

Importantly, MBS has also been found to induce regression of liver steatosis, inflammation, and fibrosis. These findings suggest a potential protective effect of MBS against the development and progression of PLC in obese individuals. By addressing underlying metabolic dysregulation and liver pathologies, MBS not only mitigates immediate health risks but also holds promise in reducing long-term cancer risks associated with obesityrelated liver diseases.

The primary aim of this research is to investigate the specific impact of metabolic and bariatric surgery on the incidence risk of primary liver cancer in individuals with morbid obesity. By analyzing existing data and conducting prospective studies, this research seeks to elucidate how weight loss and metabolic improvements achieved through MBS may influence the development and progression of PLC. Understanding these dynamics is key for developing targeted interventions and optimizing clinical management strategies for obese individuals at risk of liver-related complications, including primary liver cancer.

Furthermore, this research aims to explore potential mechanisms underlying the observed protective effects of MBS on liver health and cancer risk. By examining changes in liver pathology, metabolic parameters, and cancer incidence postsurgery, insights can be gained into how MBS modifies the oncogenic pathways influenced by obesity-associated metabolic dysregulation. Such insights not only inform clinical practice but also contribute to broader efforts in cancer prevention and management among high-risk populations.

In conclusion, metabolic and bariatric surgery represents a transformative approach in the management of morbid obesity, offering profound benefits beyond weight loss alone. The potential role of MBS in reducing the incidence risk of primary liver cancer underscores its significance in mitigating the health burden associated with obesity-related liver diseases. Through rigorous investigation and comprehensive analysis, this research aims to provide critical evidence supporting the integration of MBS into comprehensive strategies for cancer prevention and improving outcomes in individuals with morbid obesity.