Risk Factors for Postoperative Recurrence in Korean Patients with Crohn's Disease.
Background/Aims
A considerable number of patients with Crohn's disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn's disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients.


Methods
Clinical data of 372 patients with Crohn's disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed.


Results
Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence.


Conclusions
Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence.
['Kim|Sung Bae|SB|0000-0002-7692-466X', 'Cheon|Jae Hee|JH|0000-0002-2282-8904', 'Park|Jae Jun|JJ|0000-0001-9974-1658', 'Kim|Eun Soo|ES|0000-0003-0806-9136', 'Jeon|Seong Woo|SW|0000-0002-9539-9389', 'Jung|Sung-Ae|SA|0000-0001-7224-2867', 'Park|Dong Il|DI|0000-0003-2307-8575', 'Lee|Chang Kyun|CK|0000-0002-4279-3825', 'Im|Jong Pil|JP|0000-0003-1584-0160', 'Kim|You Sun|YS|0000-0002-5156-3458', 'Kim|Hyun Soo|HS|0000-0003-4834-0496', 'Lee|Jun|J|0000-0002-8060-9646', 'Eun|Chang Soo|CS|0000-0001-6533-9644', 'Lee|Jeong Mi|JM|0000-0003-0878-5802', 'Jang|Byung Ik|BI|0000-0002-3037-9272', 'Seo|Geom Seog|GS|0000-0001-8789-7989']
D000293:Adolescent D000328:Adult D003424:Crohn Disease D016099:Endoscopy, Gastrointestinal D005260:Female D006801:Humans D015994:Incidence D008297:Male D011183:Postoperative Complications D011184:Postoperative Period D012008:Recurrence D056910:Republic of Korea D012307:Risk Factors D016896:Treatment Outcome D055815:Young Adult
Risk factors Recurrence Surgery Thiopurine Crohn disease