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Techniques in Coloproctology

, Volume 18, Issue 1, pp 23–28 | Cite as

Management of colorectal cancer in patients with inflammatory bowel disease

  • D. O. Kavanagh
  • M. C. Carter
  • D. Keegan
  • G. Doherty
  • M. J. Smith
  • J. M. P. Hyland
  • H. Mulcahy
  • K. Sheahan
  • P. R. O’ Connell
  • D. P. O’ Donoghue
  • D. C. Winter
Original Article

Abstract

Background

This study evaluated the clinicopathological features and survival rates of patients with inflammatory bowel disease who developed colorectal cancer (CRC).

Methods

A retrospective review was performed on a prospectively maintained institutional database (1981–2011) to identify patients with inflammatory bowel disease who developed CRC. Clinicopathological parameters, management and outcomes were analysed.

Results

A total of 2,843 patients with inflammatory bowel disease were identified. One thousand six hundred and forty-two had ulcerative colitis (UC) and 1,201 had Crohn’s disease (CD). Following exclusion criteria, there were 29 patients with biopsy-proven colorectal carcinoma, 22 of whom had UC and 7 had CD. Twenty-six patients had a preoperative diagnosis of malignancy/dysplasia; 16 of these were diagnosed at surveillance endoscopy. Nodal/distant metastasis was identified at presentation in 47 and 71 % of the UC and CD group, respectively. Operative morbidity for UC and CD was 33 and 17 %, respectively. Despite the less favourable operative outcomes following surgery management of UC-related CRC, overall 5-year survival was significantly better in the UC group compared to the CD group (41 vs. 29 %; p = 0.04) reflecting the difference in stage at presentation between the two groups.

Conclusions

Patients who undergo surgery for UC-related CRC have less favourable short-term outcomes but present at a less advanced stage and have a more favourable long-term prognosis than similar patients with CRC and CD.

Keywords

Crohn’s disease Ulcerative colitis Colorectal cancer Dysplasia Prognosis Screening 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • D. O. Kavanagh
    • 1
    • 2
  • M. C. Carter
    • 1
    • 2
  • D. Keegan
    • 1
    • 2
  • G. Doherty
    • 1
    • 2
  • M. J. Smith
    • 1
    • 2
  • J. M. P. Hyland
    • 1
    • 2
  • H. Mulcahy
    • 1
    • 2
  • K. Sheahan
    • 1
    • 2
  • P. R. O’ Connell
    • 1
    • 2
  • D. P. O’ Donoghue
    • 1
    • 2
  • D. C. Winter
    • 1
    • 2
  1. 1.Center for Colorectal DiseaseSt. Vincent’s University HospitalDublinIreland
  2. 2.School of Medicine and Medical SciencesUniversity College DublinDublinIreland

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