Risk of Development of More-advanced Lesions in Patients With Inflammatory Bowel Diseases and Dysplasia.

Cremer, Anneline; Demetter, Pieter; De Vos, Martine; Rahier, Jean-Francois; Baert, Filip; Moreels, Tom; Macken, Elisabeth; Louis, Edouard; Ferdinande, Liesbeth; Fervaille, Caroline; Dedeurwaerdere, Franceska; BLETARD, Noëlla; Driessen, Ann; De Hertogh, Gert; Vermeire, Severine; Franchimont, Denis

doi:10.1016/j.cgh.2019.05.062

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Risk of Development of More-advanced Lesions in Patients With Inflammatory Bowel Diseases and Dysplasia.

Cremer, Anneline; Demetter, Pieter; De Vos, Martine et al.

2019 • In Clinical Gastroenterology and Hepatology

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https://hdl.handle.net/2268/248655

DOI
10.1016/j.cgh.2019.05.062

PubMed
31202983

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Keywords :

CRC; Colorectal Cancer; Crohn's Disease; Endoscopy Resection; Ulcerative Colitis

Abstract :

[en] BACKGROUND & AIMS: Patients with inflammatory bowel diseases (IBD) have increased risks of dysplasia and colitis-associated cancer (CAC). We evaluated the risk of development of high-grade dysplasia (HGD) or CAC after diagnosis of dysplasia using data from a national cohort of patients with IBD. METHODS: We performed a multicenter retrospective analysis of data collected from 7 tertiary referral regional or academic centers in Belgium. In searches of IBD pathology databases, we identified 813 lesions (616 low-grade dysplasias [LGDs], 64 high-grade dysplasias [HGDs], and 133 CACs) in 410 patients with IBD: 299 had dysplasia (73%) and 111 had CAC (27%). The primary aim was to determine the risk of more-advanced lesions after diagnosis of LGD or HGD. RESULTS: Of the 287 patients with LGD, 21 (7%) developed more-advanced lesions (HGD or CAC) after a median time period of 86 months (interquartile range, 34-214). Of the 28 patients with HGD, 4 (14%) developed CAC after a median time period of 180 months (interquartile range, 23-444). The overall cumulative incidence of CAC at 10 years after an initial diagnosis of HGD was 24.3% and after an initial diagnosis of LGD was 8.5% (P < .05). Metachronous lesions, non-polypoid lesions, and colonic stricture were associated with risk of occurrence of more-advanced lesions after LGD (P < .05). Of the 630 dysplastic lesions identified during endoscopy, 545 (86%) were removed during the same procedure or during a follow-up endoscopy or by surgery. Of 111 patients with CAC, 95 (86%) did not have prior detection of dysplasia and 64 of these 95 patients (67%) developed CAC outside of the screening or surveillance period recommended by the European Crohn's and Colitis Organisation. CONCLUSIONS: In an analysis of pathology data from 7 medical centers in Belgium, we found a low rate of detection of more-advanced lesions following detection of LGD or HGD-taking into account that most of the lesions were removed. Main risk factors for development of more-advanced lesions after LGD were metachronous lesions, non-polypoid lesions, and colon strictures.

Disciplines :

Gastroenterology & hepatology

Author, co-author :

Cremer, Anneline

Demetter, Pieter

De Vos, Martine

Rahier, Jean-Francois

Baert, Filip

Moreels, Tom

Macken, Elisabeth

Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie

Ferdinande, Liesbeth

Fervaille, Caroline

More authors (6 more)

Language :

English

Title :

Risk of Development of More-advanced Lesions in Patients With Inflammatory Bowel Diseases and Dysplasia.

Publication date :

2019

Journal title :

Clinical Gastroenterology and Hepatology

ISSN :

1542-3565

eISSN :

1542-7714

Publisher :

W. B. Saunders Co., United Kingdom

Additional URL :

https://www.sciencedirect.com/science/article/pii/S1542356519306457?via%3Dihub

Commentary :

Available on ORBi :

since 19 June 2020

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