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Session: ePoster: IBD 5 (Mon115)

EP794 - Outcomes of Segmental Resection for Inflammatory Bowel Disease-Associated Colorectal Cancer With Long Term Follow Up

Monday, May 12, 2025
1:47 PM – 1:52 PM PT

    ePoster Presenter(s)

  • Joshua A. De Marchi, MB BCh BAO (he/him/his)

    Clinical Fellow
    North Devon Trust
    Brayford, England, United Kingdom

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • Mantaj S. Brar, MD MSc (he/him/his)

    Assistant Professor
    University of Toronto
    University of Toronto
    Toronto, Ontario, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • AD

    Anthony De Buck Van Overstraeten, Associate Professor

    Colorectal Surgeon
    University of Toronto
    Toronto, Ontario, Canada

    Disclosure information not submitted.

  • JH

    Jessica Holland, MD

    Assistant Professor NOSM
    Thunder Bay Regional Health Science Center
    Thunder Bay, Ontario, Canada

    Disclosure information not submitted.

  • TA

    Tharani Anpalagan, MD

    PGY2 Internal Medicine
    University of Toronto
    Toronto, Ontario, Canada

    Disclosure information not submitted.

  • JC

    James Conner, M.D., Ph.D.

    Staff pathologist and assistant professor
    Mount Sinai Hospital and University of Toronto
    Toronto, Ontario, Canada

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Joshua A. De Marchi, MB BCh BAO: This individual has no financial relationships with ineligible companies.
Mantaj S. Brar, MD MSc: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The current standard of care for the treatment of inflammatory bowel disease (IBD)-associated colorectal cancer (CRC) or high-grade dysplasia is a total proctocolectomy. However, this practice is based on relatively limited evidence.

Methods/Interventions: We conducted a retrospective review of patients with IBD-associated CRC at a single high-volume IBD centre between 2000-2018. We selected patients who underwent segmental resection for the treatment of CRC. The primary outcomes of interest were the rate of metachronous CRC and luminal recurrence during follow-up and their oncological outcomes.

Results/Outcomes: Forty-two patients met our inclusion criteria. Thirty (71%) of patients were diagnosed pre-operatively with CRC, and synchronous cancers were found in 4 (10%) on resection. The median age was 52, and most had a long duration of IBD prior to their resection (median 25y). Median follow-up was 78 mo. Of the 32 patients who did not undergo subsequent extended resection, no patients were diagnosed with a metachronous CRC and two patients (6%) were diagnosed with a luminal recurrence. The overall survival at 5 years was 61% (95% CI 45%, 78%) and disease-free survival was 55% (95% CI 37%, 72%). IBD phenotype was not associated with outcomes (unadjusted and adjusting for stage).

Conclusion/Discussion: Segmental resection for IBD-associated CRC was not associated with a high risk of metachronous cancer or luminal recurrence. Overall oncological outcomes were poor suggesting that the initial CRC prognosis may overshadow the risk of metachronous cancer.