Annals of Coloproctology

Original Articles

Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology

Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy: Yoo Na Lee, Jong Lyul Lee, Chang Sik Yu, Jong Beom Kim, Seok-Byung Lim, In Ja Park, Young Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Jin Cheon Kim; Ann Coloproctol. 2021;37(2):101-108. Published online April 30, 2021; DOI: https://doi.org/10.3393/ac.2020.11.02

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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.

Citations

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Perianal Fistulizing Crohn’s Disease–Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus
Serre-Yu Wong, Cathy Rowan, Elvira Diaz Brockmans, Cindy C.Y. Law, Elisabeth Giselbrecht, Celina Ang, Sergey Khaitov, David Sachar, Alexandros D. Polydorides, Leon Shin-han Winata, Bram Verstockt, Antonino Spinelli, David T. Rubin, Parakkal Deepak, Dermot
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Reduced expression of alanyl aminopeptidase is a robust biomarker of non‐familial adenomatous polyposis and non‐hereditary nonpolyposis colorectal cancer syndrome early‐onset colorectal cancer
Ye Jin Ha, Yun Jae Shin, Ka Hee Tak, Jong Lyul Park, Jeong Hwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seon Young Kim, Jin Cheon Kim
Cancer Medicine.2023; 12(8): 10091. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer
Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim
Annals of Coloproctology.2022; 38(2): 97. CrossRef

Benign GI diease, Inflammatory bowel disease

Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease: Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim; Ann Coloproctol. 2020;36(4):243-248. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.10.16.1

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Abstract PDF

Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

Citations to this article as recorded by

Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
Zeitschrift für Gastroenterologie.2024; 62(02): 261. CrossRef
Aktualisierte S2k-Leitlinie Helicobacter pylori und gastroduodenale Ulkuskrankheit der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – Juli 2022 – AWMF-Registernummer: 021–001

Zeitschrift für Gastroenterologie.2023; 61(05): 544. CrossRef
A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
JGH Open.2023; 7(5): 325. CrossRef
Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clinical and Experimental Pediatrics.2022; 65(1): 21. CrossRef
Profiling non-coding RNA levels with clinical classifiers in pediatric Crohn’s disease
Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
BMC Medical Genomics.2021;[Epub] CrossRef
Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
Soo Yeun Park
Annals of Coloproctology.2020; 36(4): 207. CrossRef

Case Report

A New Technique Using Ultra-slim Endoscopy for High-Grade Crohn's Stricture: Ga Hee Kim, Kyung-Jo Kim, Gi Ae Kim, Jee Eun Yang, Hee Jung Park, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang; J Korean Soc Coloproctol. 2012;28(5):271-274. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.271

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32 Download
3 Citations

Abstract PDF

Crohn's disease (CD) is a chronic inflammatory bowel disease of unknown etiology. Most patients with CD will eventually develop a stricturing or penetrating complication. Colonoscopic findings may predict the clinical course in patients with CD. Moreover, since CD patients are at increased risk for developing dysplasia and colorectal cancer, surveillance colonoscopy is necessary for the detection of malignancies. We describe here a CD patient with a high-grade anorectal stricture who successfully underwent a total colon examination with an ultra-slim upper endoscope after an insertion failure with a standard colonoscope and gastroscope.

Citations

Citations to this article as recorded by

ECCO Topical Review Optimising Reporting in Surgery, Endoscopy, and Histopathology
Michel Adamina, Roger Feakins, Marietta Iacucci, Antonino Spinelli, Rosanna Cannatelli, André D’Hoore, Ann Driessen, Konstantinos Katsanos, Aart Mookhoek, Pär Myrelid, Gianluca Pellino, Georgios Peros, Gian Eugenio Tontini, Monika Tripathi, Henit Yanai, M
Journal of Crohn's and Colitis.2021; 15(7): 1089. CrossRef
Super-slim endoscopy, in a patient with a Crohn’s ileocecal valve stricture, for assessment of mucosal healing
S. Pontone, C. Cicerone, F. M. Magliocca, P. Vernia
Techniques in Coloproctology.2016; 20(4): 259. CrossRef
Clinical impact of ultrathin colonoscopy for Crohn's disease patients with strictures
Kenichi Morimoto, Kenji Watanabe, Atsushi Noguchi, Takako Miyazaki, Yasuaki Nagami, Satoshi Sugimori, Noriko Kamata, Mitsue Sogawa, Tetsuya Tanigawa, Hirokazu Yamagami, Masatsugu Shiba, Kazunari Tominaga, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa
Journal of Gastroenterology and Hepatology.2015; 30(S1): 66. CrossRef

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