Detection of Dysplasia or Cancer in 3.5% of Patients With Inflammatory Bowel Disease and Colonic Strictures.
BACKGROUND & AIMS
Colonic strictures complicate inflammatory bowel disease (IBD) and often lead to surgical resection to prevent dysplasia or cancer. We assessed the frequency of dysplasia and cancer among IBD patients undergoing resection of a colorectal stricture.


METHODS
We analyzed data from the Groupe d'études et thérapeutiques des affections inflammatoires du tube digestif study. This was a nationwide retrospective study of 12,013 patients with IBD in France who underwent surgery for strictures at 16 centers from August 1992 through January 2014 (293 patients for a colonic stricture, 248 patients with Crohn's disease, 51% male, median age at stricture diagnosis of 38 years). Participants had no preoperative evidence of dysplasia or cancer. We collected clinical, endoscopic, surgical, and pathology data and information on outcomes.


RESULTS
When patients were diagnosed with strictures, they had IBD for a median time of 8 years (3-14). The strictures were a median length of 6 cm (4-10) and caused symptoms in 70% of patients. Of patients with Crohn's disease, 3 (1%) were found to have low-grade dysplasia, 1 (0.4%) was found to have high-grade dysplasia, and 2 (0.8%) were found to have cancer. Of patients with ulcerative colitis, 1 (2%) had low-grade dysplasia, 1 (2%) had high-grade dysplasia, and 2 (5%) had cancer. All patients with dysplasia or cancer received curative surgery, except 1 who died of colorectal cancer during the follow-up period. No active disease at time of surgery was the only factor associated with dysplasia or cancer at the stricture site (odds ratio, 4.86; 95% confidence interval, 1.11-21.27; P = .036).


CONCLUSIONS
In a retrospective study of patients with IBD undergoing surgery for colonic strictures, 3.5% were found to have dysplasia or cancer. These findings can be used to guide management of patients with IBD and colonic strictures.
['Fumery|Mathurin|M|', 'Pineton de Chambrun|Guillaume|G|', 'Stefanescu|Carmen|C|', 'Buisson|Anthony|A|', 'Bressenot|Aude|A|', 'Beaugerie|Laurent|L|', 'Amiot|Aurelien|A|', 'Altwegg|Romain|R|', 'Savoye|Guillaume|G|', 'Abitbol|Vered|V|', 'Bouguen|Guillaume|G|', 'Simon|Marion|M|', 'Duffas|Jean-Pierre|JP|', 'Hébuterne|Xavier|X|', 'Nancey|Stéphane|S|', 'Roblin|Xavier|X|', 'Leteurtre|Emmanuelle|E|', 'Bommelaer|Gilles|G|', 'Lefevre|Jeremie H|JH|', 'Brunetti|Francesco|F|', 'Guillon|Françoise|F|', 'Bouhnik|Yoram|Y|', 'Peyrin-Biroulet|Laurent|L|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D003110:Colonic Neoplasms D003251:Constriction, Pathologic D005260:Female D005602:France D006801:Humans D015212:Inflammatory Bowel Diseases D008297:Male D008875:Middle Aged D011230:Precancerous Conditions D015995:Prevalence D012189:Retrospective Studies D055815:Young Adult
CD Carcinogenesis Colon Cancer Risk Factors GETAID Study UC