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Poster display session

102P - Clinical features of anorectal cancer in patients with Crohn’s disease: Japanese single center study

Date

23 Nov 2019

Session

Poster display session

Topics

Tumour Site

Colon and Rectal Cancer

Presenters

Kazuhiro Watanabe

Citation

Annals of Oncology (2019) 30 (suppl_9): ix30-ix41. 10.1093/annonc/mdz421

Authors

K. Watanabe1, A. Kohyama1, H. Suzuki1, T. Kajiwara1, H. Karasawa1, S. Ohnuma1, H. Musha1, T. Kamei2, T. Naitoh2, M. Unno2

Author affiliations

  • 1 Surgery, Graduate School of Medicine, Tohoku University, 980-8575 - Sendai/JP
  • 2 Department Of Surgery, Tohoku University Graduate School of Medicine, 980-8574 - Sendai/JP

Resources

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Abstract 102P

Background

Patients with long-standing Crohn’s disease (CD) are at a high risk of development of anorectal cancer (ARC), however, the clinical features of ARC complicating CD are still uncertain. The aim of the present study was to clarify the clinical features of ARC complicating CD.

Methods

From 1995 to 2018, 483 patients with CD underwent surgery in our hospital. Of the 483 patients, 14 patients (2.9%) were diagnosed with ARC. A detailed review of the medical records of the patients was undertaken.

Results

The median age at diagnosis of ARC was 45 years (25-72 yrs). The median time interval between the diagnosis of CD and ARC was 21 years (7-40 yrs). Eight patients had fecal diversion because of their perianal disease. Ten patients had cancer-related symptoms. The other 4 patients had no cancer-related symptom, but serum CEA was elevated in the 2 of the 4 patients. The 4 patients were diagnosed by cancer surveillance biopsy and 3 of the 4 patients (75%) underwent R0 resection. On the other hand, only 2 of the 10 patients (20%) underwent R0 resection in patients who had cancer-related symptom at the diagnosis of ARC. The surgical procedures were as follows: abdominoperineal resection (n = 6), total pelvic exenteration (n = 3), total proctocolectomy (n = 1), loop ileostomy (n = 3), and exploratory laparotomy (n = 1). UICC staging was as follows: stage I;2. stageII;3, stageIII;4, stageIV;5. After the surgery, chemoradiotherapy was performed in 4 patients, chemotherapy in 4, and radiotherapy in 1. All the patients who underwent R0 resection achieved 5-year relapse free survival, while the 1-year / 2-year overall survival rate of the patients’ group who underwent R1 and R2 resection was 75%/50% (R1) and 40%/0% (R2), respectively.

Conclusions

ARC was not rare in the patients with long-standing CD. The prognosis is poor in patients’ group with R1/R2 resection, while, patients’ group who achieved R0 resection is good. There is a pressing need to develop strategies for the early detection of ARC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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