Colorectal carcinoma (CRC) in inflammatory bowel disease (IBD): LTP53

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Aim:To determine the clinicopathological features and survival rates of IBD patients with CRC.Method:Patients operated between 1992 and 2009 were reviewed and divided into two groups: Crohn's colitis (CC) and ulcerative colitis (UC). Factors studied included age, gender, disease duration, extent of colitis, surgicalprocedure, tumor stage, and survival.Results:Fifty-three patients (27 men, 40 UC) were analyzed. Median disease durationprior to CRC was 21 years, longer in UC patients (P = 0.04). CRC was diagnosed before operation in 82%. The mean age at operation was 54 years. One third were treated with immunosuppressive drugs. Twentyeight patients had colon cancer, 23 had rectal cancer, and two patients had more than one cancer; all cancers occurred in segments of colitis. All examined parameters were comparable between the groups. Half were diagnosed in an advanced stage (36% stage III; 17% stage IV). At a mean follow up of 56 ± 65 months 60% were alive (54% disease free) and 40% were dead, cancer related. Five-year survival was 61% for UC and 37% for CC patients (P = NS).Conclusion:CRC in IBD patients is frequently diagnosed in an advanced stage, contributing to their poorprognosis. Long term surveillance is recommended for patients with longstanding IBD colitis.

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