Does fundoplication change the risk of esophageal cancer in the setting of GERD?

The effect of a surgical antireflux procedure on the risk of cancer in those with GERD and Barrett's esophagus is unclear. Although some authorities have suggested that a surgical antireflux procedure might be superior to medical management for the prevention of cancer, the cumulative data do not demonstrate that those patients undergoing surgery have any decrement in cancer risk compared to those who receive medication. Most data available to assess the effect of surgery on cancer risk come from case series. These data are of very limited utility, because of differences in the baseline composition of groups undergoing medical and surgical therapy. Until more data are available, patients should not be advised to undergo surgical fundoplication as an antineoplastic measure.