Cancer in universal and left-sided ulcerative colitis: Clinical and pathologic features

A. J. Greenstein, D. B. Sachar, A. Pucillo, G. Vassiliades, H. Smith, I. Kreel, S. A. Geller, H. D. Janowitz, A. H. Aufses

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26 Scopus citations

Abstract

Cancer developed in 30 of 267 ulcerative colitis patients admitted to The Mount Sinai Hospital between 1960 and 1976. There were 26 patients with 29 colorectal cancers, and four patients with extraintestinal cancers. Colorectal cancers in this series were more often multiple and more proximal in distribution than colon cancers in the noncolitis population. Signs specifically associated with colorectal cancer included a palpable abdominal mass, intestinal stricture and obstruction, and late recrudescence of symptoms. Twenty-one of the 26 patients with colorectal cancer had universal colitis and five had left-sided disease. Compared to a standard population, the observed-to-expected (O/E) ratio of colorectal cancer incidence among all the authors' ulcerative colitis patients was eight, with the ratio being 11 in universal colitis and three in left-sided disease. It is important to recognize that after a sufficiently long interval, cancer may develop in left-sided as well as in universal ulcerative colitis. The mortality from colorectal cancer was 50% at 18 months, with ten of 13 deaths due to metastases. There were ten (38%) five-year survivors. Long-term survival was not limited to patients with subclinical cancers, since eight of the nine 5-year survivors studied by barium enema had positive radiologic findings preoperatively. The long-term mortality from colitis-associated cancer did not appear to be worse than that from colorectal cancer in the general population.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalMount Sinai Journal of Medicine
Volume46
Issue number1
StatePublished - 1979

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