Low risk for CRC with dysplasia resection in IBD patients
After dysplasia resection in patients with inflammatory bowel disease, risk for colorectal cancer was low, according to results published in Gastrointestinal Endoscopy.
“This is a novel finding of this study and seems to support the hypothesis that tumor progression in inflammatory bowel segment does not always follow the [low-grade dysplasia (LGD)] to [high-grade dysplasia (HGD)] to cancer pathway,” Babu P. Mohan, MD, from the department of gastroenterology and hepatology at the University of Utah Health, and colleague wrote. “The failure to achieve statistical significance could be related to insufficient sample size and variability in the definition of outcomes in the individual studies.”
Mohan and colleagues used multiple databases to identify 18 studies that reported on incidence and/or recurrence of neoplasia after resection of dysplasia in patients with IBD. In total, 1,037 patients with IBD had undergone endoscopic resection for 1,428 colonic lesions. Investigators pooled study outcomes to estimate neoplasia risk after dysplasia in patients with IBD.
The pooled risk after lesion resection, per 1,000 person years of follow-up, after CRC was 2 (95% CI, 0-3). Additionally, the pooled risk for high-grade dysplasia was 2 (95% CI, 1-3) and the pooled risk for a lesion was 43 (95% CI, 30-57).
According to the researchers, the reported outcomes were not impacted by meta-regression analysis based on lesion location, lesion size, lesion type (Paris-I, Paris-II), endoscopic resection technique and lesion histology.
“Although CRC and HGD were unusual after endoscopic treatment, the recurrence of any dysplasia was not unusual,” Mohan and colleagues wrote. “However, many of the recurrent lesions could be managed endoscopically highlighting the effectiveness of endoscopic resection and follow-up for patients with dysplastic lesions.”