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KMID : 1141920210370020101
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Annals of Coloproctology
2021 Volume.37 No. 2 p.101 ~ p.108
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Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy
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Lee Yoo-Na
Lee Jong-Lyul
Yu Chang-Sik
Kim Jong-Beom
Lim Seok-Byung
Park In-Ja
Yoon Young-Sik
Kim Chan-Wook
Yang Suk-Kyun
Ye Byong-Duk
Park Sang-Hyoung
Kim Jin-Cheon
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Abstract
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Purpose: Carcinoma arising from Crohn disease (CD) is rare, and there is no clear guidance on how to properly screen for at-risk patients and choose appropriate care. This study aimed to evaluate the clinicopathological characteristics, treatment, and oncologic outcomes of CD patients diagnosed with colorectal cancer (CRC).
Methods: Using medical records, we retrospectively enrolled a single-center cohort of 823 patients who underwent abdominal surgery for CD between January 2006 and December 2015. CD-associated CRC patients included those with adenocarcinoma, lymphoma, or neuroendocrine tumors of the colon and rectum.
Results: Nineteen patients (2.3%) underwent abdominal surgery to treat CD-associated CRC. The mean duration of CD in the CD-associated CRC group was significantly longer than that in the benign CD group (124.7 ± 77.7 months vs. 68.9 ± 60.2 months, P = 0.006). The CD-associated CRC group included a higher proportion of patients with a history of perianal disease (73.7% vs. 50.2%, P = 0.035) and colonic location (47.4% vs. 6.5%, P = 0.001). Among 19 CD-associated CRC patients, 17 (89.5%) were diagnosed with adenocarcinoma, and of the 17 cases, 15 (88.2%) were rectal adenocarcinoma. On multivariable analyses for developing CRC, only colonic location was a risk factor (relative risk, 7.735; 95% confidence interval, 2.862?20.903; P = 0.001).
Conclusion: Colorectal malignancy is rare among CD patients, even among patients who undergo abdominal surgery. Rectal adenocarcinoma accounted for most of the CRC, and colonic location was a risk factor for developing CRC.
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KEYWORD
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Crohn disease, Colorectal neoplasms, Surgery, Outcomes
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