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International Session (Symposium)9 (JGES・JSGE・JSGS)
Sat. October 14th   14:40 - 17:00   Room 11: Fukuoka International Congress Center 502+503
Comparison of clinical features of CAC and sporadic tumor in patients with ulcerative colitis
M. Naganuma1, Y. Iwao1, T. Kanai1
1Gastroenterology and Hepatology, Keio University
Background: Although the incidence of ulcerative colitis (UC) related colorectal cancer (CAC) is increased, it should also be recognized that sporadic tumors (ST) develop as older. In this study, the clinical features and prognosis are investigated in patients with CAC and ST. Methods: Among 248 UC patients who had tumor, the clinical features and prognosis were compared between 69 patients (86 lesions) with CAC (CACgroup) and 42 patients (57 lesions) who underwent surgical or endoscopic resection within the presence of the past/present inflammation of UC (STgroup).Results: The age of UC onset and tumor detection, percentage of chronic persistent type and the Mayo endoscopic score is different between CAC and ST group. The percentage of advanced cancer and pathological findings with por/muc/sig was higher in CAC group than ST group. All lesions in ST group could distinguish the lesions from the surrounding mucosa while more than half of lesions in CAC were indistinct without magnifying colonoscopy. In ST group who received local resections, 4 patients after local resections observed ectopic CAC or LGD during follow-up. Although mortality from cancer was 7% (5/69) in CAC group, no death due to cancer observed in patients whose lesions were found as intraepitherial neoplasia (IEN). Conclusion: After the sporadic lesions were resected, the occurrence of CAC/dysplasia should be cautioned. Even in CAC group, prognosis is well in patients with IEN.
Index Term 1: ulcerative colitis
Index Term 2: colitis associated cancer
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