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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