Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease
Abstract Purpose Colorectum diversion with a proximal stoma is often the preferred surgical approach in patients with Crohn's disease-related anorectal lesions or refractory colitis. To date, few studies have assessed the incidence and prognosis of cancer in the diverted anorectal segments. Thi...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-04-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-021-01751-3 |
| _version_ | 1818330002097176576 |
|---|---|
| author | Hirosuke Kuroki Akira Sugita Kazutaka Koganei Kenji Tatsumi Ryo Futatsuki Eiichi Nakao Nao Obara Katsuhiko Arai |
| author_facet | Hirosuke Kuroki Akira Sugita Kazutaka Koganei Kenji Tatsumi Ryo Futatsuki Eiichi Nakao Nao Obara Katsuhiko Arai |
| author_sort | Hirosuke Kuroki |
| collection | DOAJ |
| description | Abstract Purpose Colorectum diversion with a proximal stoma is often the preferred surgical approach in patients with Crohn's disease-related anorectal lesions or refractory colitis. To date, few studies have assessed the incidence and prognosis of cancer in the diverted anorectal segments. This study aimed to evaluate the clinical characteristics and prognosis of anorectal cancer associated with Crohn's disease following fecal diversion. Methods This was a retrospective study based on medical records of patients diagnosed with Crohn’s disease between 1999 and 2020. It was conducted at Yokohama Municipal Citizen’s Hospital. Patients diagnosed with anorectal cancer following fecal diversion were identified, and their prognosis was the primary outcome measure. Results Among 1615 patients, 232 patients (14%) underwent colorectum diversion. Of those 232 patients, 11 were diagnosed with anorectal cancer following fecal diversion, ten were diagnosed with advanced cancer, 10 underwent abdominoperineal resection, and eight died. 1 could not undergo resection due to multiple lung metastasis and died. The overall five-year survival rate in patients diagnosed with anorectal cancer following fecal diversion was 20%. Conclusion Crohn's disease-associated anorectal cancer following fecal diversion was challenging to diagnose early, and patients had a poor prognosis even after curative resection. Early abdominoperineal resection may be considered for patients with Crohn's disease who cannot benefit from cancer screening and surveillance due to difficulty accessing the anorectal stricture via endoscopy. |
| first_indexed | 2024-12-13T12:57:01Z |
| format | Article |
| id | doaj.art-86882a80c68e4a8989050c3fe4e7515e |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-13T12:57:01Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-86882a80c68e4a8989050c3fe4e7515e2022-12-21T23:45:09ZengBMCBMC Gastroenterology1471-230X2021-04-012111910.1186/s12876-021-01751-3Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s diseaseHirosuke Kuroki0Akira Sugita1Kazutaka Koganei2Kenji Tatsumi3Ryo Futatsuki4Eiichi Nakao5Nao Obara6Katsuhiko Arai7Department of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalDepartment of Surgery for Inflammatory Bowel Disease, Yokohama Municipal Citizen’s HospitalAbstract Purpose Colorectum diversion with a proximal stoma is often the preferred surgical approach in patients with Crohn's disease-related anorectal lesions or refractory colitis. To date, few studies have assessed the incidence and prognosis of cancer in the diverted anorectal segments. This study aimed to evaluate the clinical characteristics and prognosis of anorectal cancer associated with Crohn's disease following fecal diversion. Methods This was a retrospective study based on medical records of patients diagnosed with Crohn’s disease between 1999 and 2020. It was conducted at Yokohama Municipal Citizen’s Hospital. Patients diagnosed with anorectal cancer following fecal diversion were identified, and their prognosis was the primary outcome measure. Results Among 1615 patients, 232 patients (14%) underwent colorectum diversion. Of those 232 patients, 11 were diagnosed with anorectal cancer following fecal diversion, ten were diagnosed with advanced cancer, 10 underwent abdominoperineal resection, and eight died. 1 could not undergo resection due to multiple lung metastasis and died. The overall five-year survival rate in patients diagnosed with anorectal cancer following fecal diversion was 20%. Conclusion Crohn's disease-associated anorectal cancer following fecal diversion was challenging to diagnose early, and patients had a poor prognosis even after curative resection. Early abdominoperineal resection may be considered for patients with Crohn's disease who cannot benefit from cancer screening and surveillance due to difficulty accessing the anorectal stricture via endoscopy.https://doi.org/10.1186/s12876-021-01751-3Crohn's diseaseFecal diversionAnorectal cancerAbdominoperineal resectionSurveillanceStoma |
| spellingShingle | Hirosuke Kuroki Akira Sugita Kazutaka Koganei Kenji Tatsumi Ryo Futatsuki Eiichi Nakao Nao Obara Katsuhiko Arai Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease BMC Gastroenterology Crohn's disease Fecal diversion Anorectal cancer Abdominoperineal resection Surveillance Stoma |
| title | Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease |
| title_full | Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease |
| title_fullStr | Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease |
| title_full_unstemmed | Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease |
| title_short | Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease |
| title_sort | clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with crohn s disease |
| topic | Crohn's disease Fecal diversion Anorectal cancer Abdominoperineal resection Surveillance Stoma |
| url | https://doi.org/10.1186/s12876-021-01751-3 |
| work_keys_str_mv | AT hirosukekuroki clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT akirasugita clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT kazutakakoganei clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT kenjitatsumi clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT ryofutatsuki clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT eiichinakao clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT naoobara clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease AT katsuhikoarai clinicopathologicalandprognosticevaluationsofanorectalcancerafterfecaldiversionforpatientswithcrohnsdisease |