Prognosis of small bowel adenocarcinoma in Crohn's disease compares favourably with <i>de novo</i> small bowel adenocarcinoma

Wieghard, Nicole; Mongoue-Tchokote, Solange; Young, Jenny; Sheppard, Brett C.; Tsikitis, Vassiliki L.

doi:10.1111/codi.13531

Cited by 23 publications

(26 citation statements)

References 25 publications

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“…For this reason, SBA associated with Crohn's disease often occurs in the ileum, rather than in other locations. 17 Inflammation may trigger cytokines that promote cell growth, but also damage the epithelial surface, which can directly cause dysplasia, and may also allow carcinogens to pass through intercellular junctions to the cell microenvironment. Dysplastic cells are then thought to accumulate mutations in KRAS, p53, and mismatch repair proteins, which are all known drivers in the adenoma-to-carcinoma sequence.…”

Section: Immunology and Pathogenesismentioning

confidence: 99%

“…In one study, up to 8.4% of patients with SBA had coexistent Crohn's disease. 17 The risk seems to increase with disease chronicity and activity in the small intestines, and patients may develop cancer at a young age if they have had inflammatory bowel disease since childhood. The most commonly affected location is in the ileum, which is commonly involved in Crohn's disease.…”

mentioning

confidence: 99%

“…Patients who have Crohn's disease have a similar prognosis to those who do not, but may be diagnosed at an earlier stage as well. 17 Patients with metastatic SBA have an overall 5-year survival of 11 to 19%, 23,24 which is similar to metastatic colorectal cancer. Patients with colorectal cancer, however, overall have 5-year survival that improved from 50% in 1977 to 66% in 2011.…”

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confidence: 99%

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Small Bowel Adenocarcinoma

Chen

Vaccaro

2018

Clinics in Colon and Rectal Surgery

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Small bowel adenocarcinoma is a clinically and anatomically distinct gastrointestinal cancer that lacks prospective data to support its optimal management. Patients with inflammatory bowel disease and inherited conditions that cause gastrointestinal polyps are at especially high risk. Due to a lack of effective surveillance programs resulting in missed or delayed diagnoses only when symptoms develop, this disease is generally discovered at an advanced stage. Surgical resection is the only treatment modality with a chance of cure. Currently accepted treatment considerations are often generalized from large bowel and pancreatic-biliary cancers, due to some anatomic and clinical parallels. Additional research, however, is desperately needed to characterize the unique molecular differences of this disease to better prognosticate patients and establish rational clinical trials that would improve their outcomes.

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Section: Immunology and Pathogenesismentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Small Bowel Adenocarcinoma

Chen

Vaccaro

2018

Clinics in Colon and Rectal Surgery

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“…management of CrD over the last two decades. Sporadic SBC (spo-SBC) patients generally have a higher median age at diagnosis -between 56.5 and 72.1 years-in comparison to both CD-SBC and CrD-SBC [2,5,5,10,24,27,29]. Risk factors for CD-SBC and CrD-SBC have not thoroughly investigated.…”

Section: Introductionmentioning

confidence: 99%

Small Bowel Carcinomas Associated with Immune-Mediated Intestinal Disorders: the Current Knowledge

Giuffrida¹,

Vanoli²,

Arpa³

et al. 2018

Preprint

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Small bowel carcinomas (SBC) are uncommon neoplasms, whose predisposing conditions include hereditary syndromes and immune-mediated intestinal disorders, including coeliac disease (CD) and Crohn’s disease (CrD). Although both CD-associated SBC (CD-SBC) and CrD-associated SBC (CrD-SBC) arise from an inflammatory background, they differ substantially in tumour cell phenotype, frequency of microsatellite instability and nuclear β-catenin expression, as well as in prognosis. For these patients, high tumor-infiltrating lymphocyte density and glandular/medullary histotype represent independent positive prognostic factors. Dysplasia adjacent to SBC is rare and characterized by intestinal phenotype and nuclear β-catenin in CD, while it is frequent and typified by gastro-pancreatobiliary marker expression and preserved membranous β-catenin in CrD. Recent evidence suggests that Epstein-Barr virus-positive dysplasia and SBC, albeit exceptional, do exist and are associated with CrD. In this review we summarize the novel pathological and molecular insights of clinical and therapeutic interest to guide the care of CD-SBC and CrD-SBC.

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“…Therefore, the authors concluded that CD does not worsen survival following treatment of SBA. 31 A retrospective cohort study examining 484 patients who were undergoing resections for stricturing CD found 6 patients (1.2%) with incidental SBA (stages I-IV). After a median follow-up of 2 years, only one patient was still alive.…”

Section: Small Bowel Malignanciesmentioning

confidence: 99%

Crohn's Disease and the Risk of Cancer

Carchman

2019

Clinics in Colon and Rectal Surgery

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Crohn's disease is associated with various intestinal and extraintestinal malignancies. This article reviews the current literature regarding Crohn's disease and subsequent risk of cancer formation. Recognition of risk factors (both modifiable and unmodifiable) is essential for prevention and appropriate screening. Future investigations into the molecular mechanisms associated with Crohn-related malignancy will provide additional insight into carcinogenesis, potential for early intervention, and identification of at-risk patients.

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Prognosis of small bowel adenocarcinoma in Crohn's disease compares favourably with de novo small bowel adenocarcinoma

Abstract: Patients with CD-associated SBA present at an earlier stage than patients with de novo SBA, they receive more surgery but similar rates of chemotherapy, and have similar OS and CSS. The presence of CD does not worsen survival after treatment of SBA.

Cited by 23 publications

References 25 publications

Small Bowel Adenocarcinoma

Small Bowel Adenocarcinoma

Small Bowel Carcinomas Associated with Immune-Mediated Intestinal Disorders: the Current Knowledge

Crohn's Disease and the Risk of Cancer

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