The risk of small bowel adenocarcinoma in patients with Crohn’s disease

Gustaw Lech; Wojciech Korcz; Emilia Kowalczyk; Andrzej Chaber; Maciej Słodkowski

doi:10.5114/pg.2020.101559

eISSN: 1897-4317
ISSN: 1895-5770

Gastroenterology Review/Przegląd Gastroenterologiczny

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4/2020
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abstract:

Original paper

The risk of small bowel adenocarcinoma in patients with Crohn’s disease

Gustaw Lech

¹

,

Wojciech Korcz

¹

,

Emilia Kowalczyk

²

,

Andrzej Chaber

¹

,

Maciej Słodkowski

¹

Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
Student Science Group at Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland

Gastroenterology Rev 2020; 15 (4): 309–313

DOI: https://doi.org/10.5114/pg.2020.101559

Online publish date: 2020/12/10

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Introduction
Small bowel adenocarcinoma (SBA) is an unusual complication of Crohn’s disease (CD).

Aim
To describe the incidence rate, clinical features, and outcomes of SBA in a group of subsequent patients with CD.

Material and methods
We retrospectively analysed outpatient and hospital records and identified a group of patients with diagnosed CD. Then we reviewed all medical records of patients who reported for follow-up visits in a 14-year period. We identified a group of 103 patients, whose medical records were evaluated for the presence of SBA.

Results
Long-term follow-up carried out in the group of consecutively treated patients with CD revealed an 0.97% incidence rate of SBA. Cancer was located in the ileum and the clinical presentation was subileus and anaemia. The patient underwent ileocaecal resection, and the postoperative period was uneventful.

Conclusions
SBA is a rare complication of CD. Although the authors are aware that the number of patients enrolled in the study is insufficient to draw far-reaching conclusions, the results obtained are significant for determination of the incidence rate of SBA in the Caucasian population of patients with CD. The key issue of effective treatment of patients with SBA was early detection of the lesion and R0 resection with proper lymphadenectomy. However, it is worth noting that in more advanced stages of SBA the future belongs to, and outcome improvement depends on, new regimes of adjuvant personalised chemotherapies. Further studies on the mechanisms of carcinogenesis in patients with CD are essential.

keywords:

The risk of small bowel adenocarcinoma in patients with Crohn’s disease

Gustaw Lech 1 , Wojciech Korcz 1 , Emilia Kowalczyk 2 , Andrzej Chaber 1 , Maciej Słodkowski 1

Crohn’s disease, inflammatory bowel disease, small bowel adenocarcinoma, cancer, bowel

Gustaw Lech

¹

,

Wojciech Korcz

¹

,

Emilia Kowalczyk

²

,

Andrzej Chaber

¹

,

Maciej Słodkowski

¹