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Surgical Treatment for Ulcerative Colitis-Associated Cancer or Dysplasia

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Colitis-Associated Cancer

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Abstract

Patients with long-standing ulcerative colitis (UC) have an increased risk of colorectal neoplasia (from dysplasia to advanced cancer) and are therefore candidates for several kinds of surgical treatments, ranging from an endoscopic resection to abdominoperineal resection and total proctocolectomy, depending on disease status. In addition to the extent of resection, patient age and sex, anal function, UC status, and type or location of the neoplasia must be taken into account in surgical decision-making. Although total proctocolectomy with ileal pouch-anal anastomosis is the gold standard for UC-associated colorectal cancer, the pros and cons of rectal mucosectomy are still debated. In addition, the postoperative administration of immunomodulators or biologics for UC is controversial. Data on the prognosis of surgically treated patients are still limited, and conclusions cannot yet be drawn. However, these patients should be closely followed for a relapse of inflammation and the recurrence of neoplasia in the residual lesion, especially in the anal transition zone. Recent, more aggressive approaches include chemoradiotherapy followed by ileal pouch-anal anastomosis or partial intersphincteric resection.

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Authors and Affiliations

  1. Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Toshimitsu Araki, Yuji Toiyama, Yoshiki Okita, Koji Tanaka, Yasuhiro Inoue, Keiichi Uchida & Masato Kusunoki

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  1. Toshimitsu Araki
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  2. Yuji Toiyama
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  3. Yoshiki Okita
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  4. Koji Tanaka
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  5. Yasuhiro Inoue
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  6. Keiichi Uchida
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  7. Masato Kusunoki
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Correspondence to Toshimitsu Araki .

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  1. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

    Masato Kusunoki

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Araki, T. et al. (2016). Surgical Treatment for Ulcerative Colitis-Associated Cancer or Dysplasia. In: Kusunoki, M. (eds) Colitis-Associated Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55522-3_6

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  • DOI: https://doi.org/10.1007/978-4-431-55522-3_6

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