|The 1st Joint Session between JDDW & KDDW & TDDW 6 (JDDW)|
|Thu. October 12th 16:00 - 17:00 Room 8: Fukuoka International Congress Center 411+412|
|Clinical outcomes of colorectal dysplasia and cancer in the Ulcerative colitis: A single center experience|
|Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine|
|Background: Risk of dysplasia and colorectal cancer increases in the ulcerative colitis (UC). We aimed to analyze the clinical outcomes of those with dysplasia/colitic cancer.
Methods: 82 UC patients with dysplasia or colitic cancer were included for this retrospective study.
Results: For the patients, whose initial diagnosis was dysplasia (n=61), treatment recommendations were as followings: endoscopic resection (ER, n=21), colectomy (n=21) and short term follow up (n=19). In the real practice, ER was done for 20 patients whose recommendation was ER, four whose initial plan was colectomy, and five who underwent short-term repeated endoscopy. Consequently, 29 underwent ER for dysplasia. Of these, 24 were followed endoscopically. During median 31.9 months of follow up period (range, 6.3 ~ 113.9 months), 17 (70.8%) had no dysplasia and 4 (16.7%) had indefinite for dysplasia. Multiple low grade dysplasia and stage IV cancer occurred in 2 (9.5%) and 1 (4.2%), respectively. In 16 patients, whose initial plans were colectomy or short-term follow-up, were followed without any treatment because of the patients' preference or refusal of colectomy. Of them, metachronous dysplasia developed in 2 (12.5%) and progression to cancer was identified in 4 (25%). All patients initially diagnosed with colitic cancer (n=21) accepted colectomy, but curative surgery was not possible in 3 (14.3%) of them due to distant metastasis.
Conclusion: ER is feasible treatment for the endoscopically resectable dysplasia in UC. However, regular surveillance is necessary to detect metachronous dysplasia and colitic cancer.