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Colorectal carcinoma in indeterminate colitis.
Bernardino C Branco1, Noam Harpaz, David B Sachar
1Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA.
Colorectal cancer (CRC) in indeterminate colitis (IC) shares features with CRC in ulcerative colitis (UC) and Crohn's disease (CD). Current surveillance for IBD may be suitable for IC patients.
Area of Science:
- Gastroenterology
- Oncology
- Colorectal Surgery
Background:
- Limited data exist on colorectal cancer (CRC) natural history in indeterminate colitis (IC).
- Inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC), Crohn's disease (CD), and IC.
- CRC risk is elevated in IBD patients.
Purpose of the Study:
- To assess clinicopathological features of CRC in IC.
- To determine survival rates for IC-associated CRC.
- To compare IC-CRC with CRC in UC and CD.
Main Methods:
- Retrospective review of 15 IC patients who developed CRC.
- Medical records analyzed from 1994-2007 at Mount Sinai Hospital.
- Complete follow-up data available for all patients.
Main Results:
- 19 adenocarcinomas identified in 15 patients; 3 had multiple cancers.
- Mean age at IC onset: 28 years; average time to CRC: 19 years.
- 5-year survival rate was 42%; 4 deaths due to CRC.
Conclusions:
- CRC in IC shares clinical and pathological features with CRC in UC and CD.
- Survival outcomes for IC-CRC are similar to UC-CRC and CD-CRC.
- Current IBD surveillance strategies appear applicable to IC patients.
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