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The risk of small bowel adenocarcinoma in patients with Crohn's disease
Gustaw Lech1, Wojciech Korcz1, Emilia Kowalczyk2
1Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland.
Introduction:
Small bowel adenocarcinoma (SBA) is an unusual complication of Crohn's disease (CD).
Aim:
To describe the incidence rate, clinical features, and outcomes of SBA in a group of subsequent patients with CD.
Material And Methods:
We retrospectively analysed outpatient and hospital records and identified a group of patients with diagnosed CD. Then we reviewed all medical records of patients who reported for follow-up visits in a 14-year period. We identified a group of 103 patients, whose medical records were evaluated for the presence of SBA.
Results:
Long-term follow-up carried out in the group of consecutively treated patients with CD revealed an 0.97% incidence rate of SBA. Cancer was located in the ileum and the clinical presentation was subileus and anaemia. The patient underwent ileocaecal resection, and the postoperative period was uneventful.
Conclusions:
SBA is a rare complication of CD. Although the authors are aware that the number of patients enrolled in the study is insufficient to draw far-reaching conclusions, the results obtained are significant for determination of the incidence rate of SBA in the Caucasian population of patients with CD. The key issue of effective treatment of patients with SBA was early detection of the lesion and R0 resection with proper lymphadenectomy. However, it is worth noting that in more advanced stages of SBA the future belongs to, and outcome improvement depends on, new regimes of adjuvant personalised chemotherapies. Further studies on the mechanisms of carcinogenesis in patients with CD are essential.
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