102P - Clinical features of anorectal cancer in patients with Crohn’s disease: Japanese single center study

Abstract

BackgroundPatients with long-standing Crohn’s disease (CD) are at a high risk of development of anorectal cancer (ARC), however, the clinical features of ARC complicating CD are still uncertain. The aim of the present study was to clarify the clinical features of ARC complicating CD. MethodsFrom 1995 to 2018, 483 patients with CD underwent surgery in our hospital. Of the 483 patients, 14 patients (2.9%) were diagnosed with ARC. A detailed review of the medical records of the patients was undertaken. ResultsThe median age at diagnosis of ARC was 45 years (25-72 yrs). The median time interval between the diagnosis of CD and ARC was 21 years (7-40 yrs). Eight patients had fecal diversion because of their perianal disease. Ten patients had cancer-related symptoms. The other 4 patients had no cancer-related symptom, but serum CEA was elevated in the 2 of the 4 patients. The 4 patients were diagnosed by cancer surveillance biopsy and 3 of the 4 patients (75%) underwent R0 resection. On the other hand, only 2 of the 10 patients (20%) underwent R0 resection in patients who had cancer-related symptom at the diagnosis of ARC. The surgical procedures were as follows: abdominoperineal resection (n = 6), total pelvic exenteration (n = 3), total proctocolectomy (n = 1), loop ileostomy (n = 3), and exploratory laparotomy (n = 1). UICC staging was as follows: stage I;2. stageII;3, stageIII;4, stageIV;5. After the surgery, chemoradiotherapy was performed in 4 patients, chemotherapy in 4, and radiotherapy in 1. All the patients who underwent R0 resection achieved 5-year relapse free survival, while the 1-year / 2-year overall survival rate of the patients’ group who underwent R1 and R2 resection was 75%/50% (R1) and 40%/0% (R2), respectively. ConclusionsARC was not rare in the patients with long-standing CD. The prognosis is poor in patients’ group with R1/R2 resection, while, patients’ group who achieved R0 resection is good. There is a pressing need to develop strategies for the early detection of ARC. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.