Colorectal neoplasia in Crohn's colitis: a retrospective comparative study with ulcerative colitis

• Published in: Histopathology Vol. 50; no. 5; pp. 574 - 583
• Main Authors: Svrcek, M, Cosnes, J, Beaugerie, L, Parc, R, Bennis, M, Tiret, E, Fléjou, J-F
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-04-2007; Blackwell; Wiley
• Subjects: Adenocarcinoma, Mucinous - complications; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Chemical Sciences; Colitis - complications; Colitis - pathology; Colitis - surgery; colorectal cancer; Colorectal Neoplasms - complications; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Crohn Disease - complications; Crohn Disease - pathology; Crohn Disease - surgery; Crohn's colitis; dysplasia; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; inflammatory bowel disease; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Organic chemistry; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Precancerous Conditions - pathology; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Dysplasia; Rectal disease; Colorectal cancer; Malignant tumor; Retrospective; inflammatory bowel disease; Inflammatory disease; Colonic disease; Crohn disease; Anatomic pathology; Digestive diseases; Intestinal disease; Colitis; Crohn's colitis; Comparative study; Ulcerative colitis
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2007.02663.x

Aims:  To determine the clinicopathological features of colorectal cancer (CRC) in Crohn's disease (CD).
Methods and results:  All histological slides from surgical specimens with inflammatory bowel disease‐related colorectal neoplasia examined in our hospital between 1990 and 2005 were reviewed. We identified 18 CRCs in 16 patients with CD and compared them with 57 CRCs in 41 patients with ulcerative colitis (UC). We also studied 25 patients with dysplasia without cancer (CD 2, UC 23). When CD and UC were compared, the median age at diagnosis of cancer (CD 52 years, UC 51 years), the frequency of mucinous adenocarcinoma (CD 16.7%, UC 17.5%) and the frequency of dysplasia adjacent to and distal from cancer (CD 56.3 and 37.5%, UC 65.8 and 39%, respectively) were similar. All neoplastic lesions occurred in areas affected by inflammatory bowel disease.
Conclusions:  CRC complicating CD and UC shares many clinicopathological features, in particular similar frequencies of dysplasia, both adjacent and distal, with cancer. Thus, surveillance for patients with Crohn's colitis should be similar to that for patients with UC. Consideration should be given to a more extensive UC‐like surgical approach instead of segmental resection of the involved area.