Matteo Rottoli1, Marta Tanzanu2, Francesca Di Candido3, Francesco Colombo4, Alice Frontali5, Pramodh C Chandrasinghe6, Gianluca Pellino7, Matteo Frasson7, Janindra Warusavitarne6, Yves Panis5, Gianluca M Sampietro4, Antonino Spinelli3, Gilberto Poggioli2. 1. Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy. Electronic address: matteo.rottoli2@unibo.it. 2. Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy. 3. Colon and Rectal Surgery Division, Humanitas Clinical and Research Center, Department of Biomedical Science, Humanitas University, Milan, Italy. 4. Department of Surgery, Luigi Sacco University Hospital, Milan, Italy. 5. Beaujon Hospital, Department of Colorectal Surgery and University Paris VII, France. 6. St Mark's Hospital, London, United Kingdom. 7. Colorectal Unit, Hospital Universitario y Politecnico La Fe, University of Valencia, Valencia, Spain.
Abstract
BACKGROUND: Patients affected by ulcerative colitis (UC) are more likely to develop colorectal cancer, and are often diagnosed with lymph node involvement (N+) at surgery. AIM: To identify the risk factors for N+ cancer in UC patients. METHODS: Patients undergoing surgery from 2001 to 2018 in six European tertiary centres were included. N+ patients were compared to the control group (N-) for clinical variables. The evaluation of risk factors for N+ was assessed using univariate and multivariable logistic regression analyses. RESULTS: A total of 130 patients were included. Median duration of disease was 21 years (1-52). Forty patients (30.8%) were N+ at surgery. Eighteen (13.8%) developed cancer within 10 years from the onset of UC. Younger age at surgery (Odds ratio -OR- 0.96, p = 0.042), left colon location (OR 2.44, p = 0.045) and the presence of stricture (OR 5.07, p = 0.002) were associated with N+. CONCLUSION: Location in the left colon, presence of strictures and younger age strongly correlated with a higher risk of N+ cancer, which could develop before the starting point of surveillance. Duration, extension and severity of disease were not associated with N+. These results should be considered in the evaluation of risk of advanced cancer in UC patients.
BACKGROUND:Patients affected by ulcerative colitis (UC) are more likely to develop colorectal cancer, and are often diagnosed with lymph node involvement (N+) at surgery. AIM: To identify the risk factors for N+cancer in UCpatients. METHODS:Patients undergoing surgery from 2001 to 2018 in six European tertiary centres were included. N+patients were compared to the control group (N-) for clinical variables. The evaluation of risk factors for N+ was assessed using univariate and multivariable logistic regression analyses. RESULTS: A total of 130 patients were included. Median duration of disease was 21 years (1-52). Forty patients (30.8%) were N+ at surgery. Eighteen (13.8%) developed cancer within 10 years from the onset of UC. Younger age at surgery (Odds ratio -OR- 0.96, p = 0.042), left colon location (OR 2.44, p = 0.045) and the presence of stricture (OR 5.07, p = 0.002) were associated with N+. CONCLUSION: Location in the left colon, presence of strictures and younger age strongly correlated with a higher risk of N+cancer, which could develop before the starting point of surveillance. Duration, extension and severity of disease were not associated with N+. These results should be considered in the evaluation of risk of advanced cancer in UCpatients.
Authors: G Pellino; D S Keller; G M Sampietro; M Carvello; V Celentano; C Coco; F Colombo; A Geccherle; G Luglio; M Rottoli; M Scarpa; G Sciaudone; G Sica; L Sofo; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-03-02 Impact factor: 3.781