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Select patients with colorectal cancer, UC benefit from partial colectomy
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ORLANDO, Fla. — Partial colectomy may be a viable treatment for certain patients with colorectal cancer and ulcerative colitis, according to data presented at Digestive Disease Week.
In a retrospective cohort study, researchers evaluated data on 38 patients with colorectal cancer (CRC) and ulcerative colitis (UC) who were followed from October 2001 to October 2011. Patients were collected from the Veterans Affairs Health Care System, with follow-up from partial colectomy to either cancer recurrence or the most recent colonoscopy indicating no recurrence (median 5 years). The median age of the cohort at cancer diagnosis was 70 years, with a median UC duration of 16 years.
Recurrent CRC was observed in eight cases during follow-up (median time to recurrence 4 years), including six who subsequently underwent total proctocolectomy. The remaining two participants declined further cancer therapy and died. No metastasis was observed upon identification of recurrent CRC in any of the six treated cases. Recurrence-free survival occurred in 97% of the cohort at 1 year, 80% at 5 years and 67% at 10 years following partial colectomy, with a median duration of 24 ± 12 years.
The investigators concluded that partial colectomy is a viable option, particularly among older patients undergoing close endoscopic surveillance.
Elisabeth B. Cole
“The standard of care across the country is a total colectomy for this group of patients because there’s risk of recurrence of cancer and obviously risk of colitis in the retained segment,” researcher Elisabeth B. Cole, MS, gastroenterology and hepatology section of Tulane University Health Sciences Center, told Healio.com. “In a selected subgroup of patients, there may be validity in a segmental resection if there’s strict screening of the retained segment, and the physician feels as though, for whatever reason, [such as] multiple comorbidities or age, they aren’t going to be able to function well with a full colectomy.”
For more information:
Khan N. Mo1240: Colorectal Cancer Recurrence Following Partial Colectomy for Colorectal Cancer in Patients with Ulcerative Colitis. Presented at: Digestive Disease Week 2013; May 18-21, Orlando, Fla.