753 A History of Colorectal Neoplasia Is Associated With an Increased Risk of Ileo-Anal Pouch Neoplasia in a Nationwide Inflammatory Bowel Disease Cohort

2013 ◽  
Vol 144 (5) ◽  
pp. S-136-S-137
Author(s):  
Lauranne A. Derikx ◽  
Wietske Kievit ◽  
Dirk J. De Jong ◽  
Cyriel Ponsioen ◽  
Bas Oldenburg ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Colorectal Neoplasia ◽  
Increased Risk ◽  
History Of ◽  
Inflammatory Bowel

scholarly journals P307 Colorectal neoplasia risk in patients with inflammatory bowel disease and serrated lesions

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S307-S308
Author(s):  
M De Jong ◽  
S Vos ◽  
I Nagtegaal ◽  
Y van Herwaarden ◽  
L Derikx ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Colorectal Neoplasia ◽  
Classification Systems ◽  
Advanced Neoplasia ◽  
Increased Risk ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
Serrated Lesion ◽  
The Impact

Abstract Background The presence of serrated lesions (SLs) is an established risk factor for colorectal neoplasia development in the general population. However, the impact of SLs on the colorectal neoplasia risk in inflammatory bowel disease (IBD) patients is unknown. In addition, SLs might have been misclassified in IBD patients in the past, in part due to revisions of classification systems. Presently, SLs are categorised as hyperplastic lesions, sessile SLs, and traditional serrated adenomas. We aimed (1) to compare the colorectal neoplasia risk in IBD patients with SLs vs. IBD patients without SLs, and 2) to study the subclassification of SLs in IBD patients before and after histopathological review by two expert gastrointestinal pathologists. Methods We identified all IBD patients with colonic SLs from 1996 to 2019 in a tertiary referral centre using the local histopathology database. Patients with neoplasia prior to SL diagnosis were excluded. Clinical data from patients’ charts were retrieved until June 2019. A subgroup of 135 SLs was reviewed by two pathologists. The log-rank analysis was used to compare the cumulative (advanced) neoplasia incidence in IBD patients with SL vs. IBD patients without SL undergoing surveillance in the same time period. Patients were censored at the end of surveillance or at colectomy. Results We identified 376 SLs in 204 IBD patients (61.9% ulcerative colitis (UC)). In the original reports, 91.9% was classified as a hyperplastic lesion. After histopathological review, 120/136 (88%) of the SLs were confirmed (16 were no SL). Of the 120 confirmed SLs, 62.2% was classified as a sessile SL, 37.8% as a hyperplastic lesion, and 0.8% as a traditional serrated adenoma. The mean time from IBD diagnosis to the first serrated lesion was 14.3 ( ± 12.3) years. A total of 41/204 (20.0%) of patients developed neoplasia (3 CRC, 3 HGD, and 35 LGD; including 2 HGD and 17 LGD at the moment of serrated lesion detection). In the 304 patients without SL (52.6% UC), 63 developed neoplasia (20.7%; 8 CRC, 5 HGD and 50 LGD). Patients who received follow-up colonoscopies after SL (n = 127) had an increased cumulative risk of neoplasia (p < 0.01), but no increased risk of advanced neoplasia (p = 0.50) compared with the group of IBD patients without SL (Figure 1). Conclusion The presence of SLs in IBD patients was associated with a relatively high risk of synchronous colorectal neoplasia as well as an increased risk of subsequent neoplasia, although not with an increased risk of advanced neoplasia. Histopathological review confirmed the SL diagnosis in the majority of lesions, although a large proportion of the hyperplastic lesions was reclassified as a sessile SL.

scholarly journals P733 Past history of bariatric surgery associated with increased risk of new onset inflammatory bowel disease

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S455-S456 ◽  
Author(s):  
R. Ungaro ◽  
H. Chang ◽  
L. Roque Ramos ◽  
R. Fausel ◽  
J. Torres ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Past History ◽  
Increased Risk ◽  
History Of ◽  
Inflammatory Bowel ◽  
New Onset

scholarly journals P729 The SAPPHIRE registry: Safety of immunosuppression in a prospective cohort of inflammatory bowel disease patients with a HIstoRy of CancEr

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S585-S587
Author(s):  
J Axelrad ◽  
J F Colombel ◽  
E Scherl ◽  
D Lukin ◽  
S Chang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
New York ◽  
Bowel Disease ◽  
Small Sample ◽  
Recurrent Cancer ◽  
Increased Risk ◽  
History Of ◽  
Diagnosis Of Cancer ◽  
Inflammatory Bowel ◽  
History Of Cancer

Abstract Background Previous retrospective studies have demonstrated that patients with inflammatory bowel disease (IBD) exposed to anti-TNF and/or immunomodulators (IMM) following a diagnosis of cancer were not at an increased risk of new or recurrent cancer compared with those unexposed to these agents. Prospective studies are lacking and little is known about cancer risk with ustekinumab and vedolizumab. The SAPPHIRE Registry was developed to prospectively examine whether patients with IBD and a history of cancer subsequently exposed to immunosuppressive IBD therapies are at greater risk of new or recurrent cancer compared with those not exposed to immunosuppression. Methods We are longitudinally following patients with IBD and a histologically confirmed first cancer within the last five years from 8 centres affiliated with the New York Crohn’s and Colitis Organization (NYCCO) between 2017 and 2019. Patients receiving chemotherapy or radiation at enrolment, a first cancer more than 5 years prior to study entry, or recurrent cancer within the last 5 years are excluded. Cancers are categorised into luminal gastrointestinal (GI), hematologic, dermatologic, and other solid malignancies. Our primary outcome is the development of new or recurrent cancer stratified by immunosuppression exposure. Results We identified 170 patients with IBD and a history of a first cancer within the last 5 years (Table 1). The average age at IBD diagnosis was 36 years; average age at cancer diagnosis was 54 years. Patients were 49% male, 91% white, and 39% former smokers. Prior cancers were solid (78; 46%), GI (23; 14%), dermatologic (59; 35%), and hematologic (12; 7%) malignancies. Following a diagnosis of cancer, patients were exposed to IMM (38; 22%), anti-TNF (45; 26%), vedolizumab (41; 23%), ustekinumab (17; 10%), or no immunosuppression (33; 19%; Table 2). During follow-up, 13 (8%) patients developed 14 subsequent cancers (6 new, 8 recurrent) comprising 6 (43%) solid, 1 (7%) gastrointestinal, and 7 (50%) dermatologic malignancies. Compared to patients not exposed to immunosuppression, exposure to an IMM (RR 4.94, 95% CI 0.50, 48.6) or a biologic (RR 3.53, 95% CI 0.71, 17.5) was not associated with an increased risk of new or recurrent cancer. However, exposure to combination therapy with an IMM and a biologic (RR 6.81, 95% CI 1.40, 33.2) was associated with an increased risk in this small sample. Conclusion In this ongoing prospective study, exposure to immunosuppressive IBD monotherapies in patients with IBD and a recent history of cancer has so far conferred no increased risk of new or recurrent cancer. Continued enrolment will enable a more refined estimate of the safety of combination therapies.

Influence of inflammatory bowel disease on the ability of patients to tolerate systemic fluorouracil-based chemotherapy.

1996 ◽  
Vol 14 (7) ◽  
pp. 2043-2046 ◽  
Author(s):  
A Tiersten ◽  
L B Saltz
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cancer Center ◽  
Gastrointestinal Malignancy ◽  
Severe Diarrhea ◽  
Number Of Patients ◽  
Increased Risk ◽  
History Of ◽  
Inflammatory Bowel ◽  
Severe Grade

PURPOSE To evaluate the safety of administering fluorouracil (5FU)-based chemotherapy to cancer patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS We retrospectively reviewed all patients entered into the Memorial Sloan-Kettering Cancer Center clinical data base from 1985 through 1995 who had a diagnosis of IBD, had a gastrointestinal malignancy, and were treated with systemic 5FU-based chemotherapy. A total of 19 patient charts were identified and reviewed. RESULTS Fifty-three percent of patients reviewed experienced severe (grade III/IV) diarrhea on treatment. Sixty percent of patients with a history of active IBD and 40% of patients with a history of inactive IBD experienced severe diarrhea on treatment. The incidence of severe diarrhea did not appear to be substantially influenced by age, schedule of 5FU administration, concurrent radiation, or type of IBD. CONCLUSION While there does appear to be an increased risk of diarrhea exacerbation in IBD patients treated with 5FU, a substantial number of patients tolerate chemotherapy without increased difficulty. The degree of IBD activity or other clinical parameters can not be used to predict accurately the likelihood of toxicity.

Prior Colorectal Neoplasia Is Associated With Increased Risk of Ileoanal Pouch Neoplasia in Patients With Inflammatory Bowel Disease

2014 ◽  
Vol 146 (1) ◽  
pp. 119-128.e1 ◽  
Author(s):  
Lauranne A.A.P. Derikx ◽  
Wietske Kievit ◽  
Joost P.H. Drenth ◽  
Dirk J. de Jong ◽  
Cyriel Y. Ponsioen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Colorectal Neoplasia ◽  
Ileoanal Pouch ◽  
Increased Risk ◽  
Inflammatory Bowel

scholarly journals No Increased Risk of Colorectal Neoplasia in Patients With Inflammatory Bowel Disease and Postinflammatory Polyps

2019 ◽  
Vol 26 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
Michiel E de Jong ◽  
Veerle E L M Gillis ◽  
Lauranne A A P Derikx ◽  
Frank Hoentjen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Colorectal Neoplasia ◽  
Surveillance Strategy ◽  
Extensive Disease ◽  
Disease Extent ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Current Guidelines

Abstract Background Patients with inflammatory bowel disease (IBD) who have postinflammatory polyps (PIPs) may have an increased risk of developing colorectal neoplasia. Current guidelines recommend an intensified surveillance strategy in these patients, although the evidence for this recommendation is conflicting. The aim of our study was to assess whether IBD patients with PIPs are at increased risk of colorectal neoplasia. Methods We established a retrospective cohort in a tertiary IBD center with IBD patients undergoing colorectal cancer (CRC) surveillance in the current era. We compared cumulative incidences of colorectal neoplasia since IBD diagnosis between patients with and without PIPs and corrected for confounders. Second, we compared the risk of receiving a colectomy. Results In our cohort with >22 years of median follow-up, 154 of 519 patients had PIPs. PIPs were associated with extensive disease (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.61–4.42; P < 0.001) and with more severe inflammation at colonoscopy (OR, 3.54; 95% CI, 2.28–5.50; P < 0.001). After correction for confounders, the presence of PIPs was not associated with development of colorectal neoplasia (hazard ratio [HR], 1.28; 95% CI, 0.85–1.93; P = 0.24) or with development of advanced neoplasia (HR, 1.38; 95% CI, 0.52–3.68; P = 0.52). There was a higher risk of colectomy in patients with PIPs (HR, 3.41; 95% CI, 1.55–7.54; P = 0.002). Conclusion In this cohort, PIPs were associated with disease extent, inflammation, and higher rates of colectomy. However, the presence of PIPs was not associated with the development of neoplasia. These findings suggest that patients with PIPs may not need an intensified surveillance strategy.

scholarly journals Dysplasia Surveillance in Inflammatory Bowel Disease: A Cohort Study

2020 ◽  
pp. 1-9
Author(s):  
Sofia Saraiva ◽  
Isadora Rosa ◽  
Joana Moleiro ◽  
João Pereira da Silva ◽  
Ricardo Fonseca ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Bowel Disease ◽  
Univariate Analysis ◽  
Surveillance Program ◽  
Low Grade ◽  
Increased Risk ◽  
Surveillance Programs ◽  
History Of ◽  
Inflammatory Bowel

<b><i>Introduction:</i></b> Patients with colonic inflammatory bowel disease (IBD) are at an increased risk for colorectal cancer (CRC), whereby surveillance colonoscopy is recommended. <b><i>Aim:</i></b> To study the clinical and endoscopic variables associated with dysplasia in IBD patients. <b><i>Methods:</i></b> A cohort study was conducted on IBD patients who were part of a colonoscopy surveillance program between 2011 and 2016. <b><i>Results:</i></b> A total of 342 colonoscopies were performed on 162 patients (105 with ulcerative colitis [UC] and 57 with Crohn’s disease). Random biopsies were performed at least once on 81.5% of patients; 33.3% of the patients underwent chromoendoscopy (CE) at least once. Endoscopically resectable lesions were detected in 55 patients (34%), and visible lesions deemed unfit for endoscopic resection were found in 5 patients (3.1%). Overall, 62 dysplastic visible lesions (58 with low-grade dysplasia and 3 with high-grade dysplasia) and 1 adenocarcinoma were found in 34 patients. Dysplasia in random biopsies was present in 3 patients, the yield of random biopsies for dysplasia being 1.85%/patient (3/162), 1.75%/colonoscopy (6/342), and 0.25%/biopsy (9/3,637). Dysplasia detected in random biopsies was significantly associated with a personal history of visible dysplasia (<i>p</i> = 0.006). Upon univariate analysis, dysplasia was significantly associated with the type of IBD, the performance of random biopsies, and CE (<i>p</i> = 0.016/0.009/0.05, respectively). On multivariate analysis, dysplasia was associated with duration of disease. <b><i>Conclusion:</i></b> Our data confirm that patients with long-standing IBD, in particular UC, should be enrolled in dysplasia surveillance programs, and that performing CE and random biopsies seems to help in the detection of colonic neoplastic lesions.

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