Restorative Proctocolectomy for Ulcerative Colitis Complicated by Colorectal Cancer

Abstract

Restorative proctocolectomy as a single or staged procedure is a viable therapeutic option for selected chronic ulcerative colitis patients with associated colorectal cancers. Prognosis seems to be related to cancer stage. Adjuvant chemotherapy can safely be given to nondiverted patients. Appropriate use of preoperative and postoperative radiotherapy for rectal cancer patients who are otherwise candidates for restorative proctocolectomy is unknown. Long-term functional results for cancer patients are similar to those seen in chronic ulcerative colitis patients without cancer.

European evidence based consensus on surgery for ulcerative colitis

“…In general, radiation treatment is associated with an elevated risk of pouch failure (16% vs 7%), but the oncologic outcome do not seems to be affected. [240][241][242][243] Patients requiring surgery for colorectal cancer who might require adjuvant therapy need careful consideration. Preoperative staging may prove inaccurate and in order to reduce side effects of any adjuvant therapy on pouch function, a staged procedure should be performed.…”

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

“…[192][193][194][195][196][197][198] nearly 20% of uC patients with cancer who underwent an iPaa subsequently die of metastatic disease. [192][193][194][195][196][197][198] nearly 20% of uC patients with cancer who underwent an iPaa subsequently die of metastatic disease.…”

Systematic review of dysplasia after restorative proctocolectomy for ulcerative colitis

“…A further 191 articles were then excluded on the basis of the abstract as they were case reports or review articles without original data, or concerned neoplasms other than dysplasia/adenocarcinoma. A further 24 of the remaining 47 papers were excluded, of which 12 did not include an evaluation of dysplasia in either the methods or results section6, 38–49, ten duplicated published data49–58 and two failed to meet the quality standard59, 60. The 23 studies included in the analysis are listed in Table 3 5, 35, 61–81.…”