Segmental resection is a safe oncological alternative to total proctocolectomy in elderly patients with ulcerative colitis and malignancy

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Nabeel KhanE C Paulson

Abstract

The standard approach for the surgical management of colorectal cancer (CRC) in the setting of ulcerative colitis (UC) involves total proctocolectomy (TPC). However, some patients also undergo a partial resection (PR). This may be an attractive option in older patients with a high risk for surgery. The aim of this study was to compare the risk of metachronous cancer after PR or TPC for CRC in the setting of UC. This was a retrospective cohort study conducted through the Nationwide Veterans Affairs Healthcare System (VA). Patients who had UC and underwent a PR or TPC for CRC were followed from the time of their surgery to their most recent clinical follow-up. The primary outcome was development of metachronous cancer in the PR group. Secondary outcomes included surgical and medical outcomes. Fifty-nine patients were included: 24 (40.7%) underwent PR and 35 (59.3%) underwent TPC. The median age at cancer diagnosis was 73.0 and 61.7 years in PR and TPC groups, respectively (P < 0.0005). Amongst patients undergoing PR, 15 (60%) had no active UC at the time of surgery, whereas in patients undergoing TPC, at the time of surgery eight (23.5%) had no active UC (P = 0.005). No patient who underwent a partial colectomy developed a metach...Continue Reading

References

Nov 1, 1990·The New England Journal of Medicine·A EkbomH O Adami
Jan 1, 1985·American Journal of Surgery·J R OakleyR G Farmer
May 1, 1994·The British Journal of Surgery·A P LeongR K Phillips
May 1, 1996·Diseases of the Colon and Rectum·C F KollmorgenR R Dozois
Dec 29, 1999·Diseases of the Colon and Rectum·K P NugentC D Johnson
Sep 9, 2004·Alimentary Pharmacology & Therapeutics·J Eaden
Aug 22, 2006·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J LindbergJ Rutegård
Aug 8, 2007·Gastroenterology·Kathrine Frey FrøslieUNKNOWN IBSEN Group
Oct 2, 2007·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Michael D KappelmanJonathan A Finkelstein
Apr 23, 2008·Archives of Surgery·Gina K Weston-PetridesParis P Tekkis
Aug 8, 2008·The American Journal of Gastroenterology·Ashwin N AnanthakrishnanDavid G Binion
Dec 1, 2009·The Medical Clinics of North America·Hao Wu, Bo Shen
Dec 17, 2009·The British Journal of Surgery·A da Luz MoreiraI Lavery
Jan 14, 2010·The American Journal of Gastroenterology·Asher KornbluthUNKNOWN Practice Parameters Committee of the American College of Gastroenterology
Oct 13, 2011·ISRN Gastroenterology·Yasutaka ShunoHirokazu Nagawa
Feb 1, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Tine JessLaurent Peyrin-Biroulet
Apr 17, 2012·Gastroenterology Clinics of North America·Yue Li, Bo Shen
Jul 15, 2015·Diseases of the Colon and Rectum·Jessica N CohanEmily Finlayson

❮ Previous
Next ❯

Citations

Mar 4, 2020·Techniques in Coloproctology·G PellinoUNKNOWN Italian Society of Colorectal Surgery SICCR
Oct 17, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Stefan MorarasuDesmond C Winter
Feb 10, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jessica BogachHsien Seow
Apr 15, 2021·Diseases of the Colon and Rectum·Stefan D HolubarUNKNOWN Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons
Jul 13, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Anuradha R Bhama, Muneera R Kapadia

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.