Portal de investigación
Long-term oncological outcome of segmental versus extended colectomy for colorectal cancer in Crohn's disease: results from an international multicentre study.
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Sensi B
- Khan J
- Warusavitarne J
- Nardi A
- Spinelli A
- Zaghiyan K
- Panis Y
- Sampietro G
- Fichera A
- Espin-Basany E
- Konishi T
- Siragusa L
- Stefan S
- Bellato V
- Carvello M
- Adams E
- Frontali A
- Artigue M
- Marti-Gallostra M
- Pellino G
- Sica GS
Grupos
Abstract
BACKGROUND AND AIMS: Crohn's Disease increases colorectal cancer risk, with high prevalence of synchronous and metachronous cancers. Current guidelines for colorectal cancer in Crohn's Disease recommend pan-proctocolectomy. Aim of this study was to evaluate oncologic outcomes of a less invasive surgical approach. METHODS: Retrospective database analysis of Crohn's disease patients with colorectal cancer undergoing surgery at selected European and U.S. tertiary centres. Outcomes of segmental colectomy were compared with those of extended colectomy: total colectomy and pan-proctocolectomy. Primary outcome was progression-free survival. Secondary outcomes included overall survival, synchronous and metachronous colorectal cancer and major postoperative complications. RESULTS: Ninety-nine patients were included: 66 patients underwent segmental colectomy and 33 extended colectomy. Segmental colectomy patients were older (p= 0.0429), had less extensive colitis (p = 0.0002) and no pre-operatively identified synchronous lesions (p = 0.0109).Median follow up was 43 (31-62) months. There was no difference in unadjusted progression-free survival (p = 0.2570) nor in overall survival (p = 0.4191) between segmental and extended colectomy. Multivariate analysis adjusting for age, sex, ASA score and AJCC staging, confirmed no difference for progression-free survival (HR 1.00 p = 0.9993) or overall survival (HR 0.77 p = 0.6654). Synchronous and metachronous cancers incidence was 9% and 1.5% respectively. Perioperative mortality was nil and major complications were comparable (7.58% vs 6.06% p = 0.9998). CONCLUSIONS: Segmental colectomy seems to offer similar long-term outcomes to more extensive surgery. Incidence of synchronous and metachronous cancers appears much lower than previously described. Further prospective studies are warranted to confirm these results.
© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Datos de la publicación
- ISSN/ISSNe:
- 1873-9946, 1876-4479
- Tipo:
- Article
- Páginas:
- 954-962
- Factor de Impacto:
- 2,429 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
JOURNAL OF CROHNS & COLITIS OXFORD UNIV PRESS
Citas Recibidas en Web of Science: 6
Documentos
- No hay documentos
Métricas
Filiaciones
Keywords
- Colorectal Cancer; Crohn’s Disease; Surgery
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Cita
Sensi B,Khan J,Warusavitarne J,Nardi A,Spinelli A,Zaghiyan K,Panis Y,Sampietro G,Fichera A,Garcia E,Espin E,Konishi T,Siragusa L,Stefan S,Bellato V,Carvello M,Adams E,Frontali A,Artigue M,Frasson M,Marti M,Pellino G,Sica GS. Long-term oncological outcome of segmental versus extended colectomy for colorectal cancer in Crohn's disease: results from an international multicentre study. J Crohns Colitis. 2022. 16. (6):p. 954-962. IF:8,000. (1).