Dysplasia and cancer in inflammatory bowel disease:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2006
|
| Schriftenreihe: | Gastroenterology clinics of North America
35,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIII S., S. 517 - 734 Ill., graph. Darst. |
| ISBN: | 1416040153 |
Internformat
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| 245 | 1 | 0 | |a Dysplasia and cancer in inflammatory bowel disease |c guest ed. Francis A. Farraye |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2006 | |
| 300 | |a XIII S., S. 517 - 734 |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
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| 490 | 1 | |a Gastroenterology clinics of North America |v 35,3 | |
| 650 | 4 | |a Colitis, Ulcerative | |
| 650 | 4 | |a Colorectal Neoplasms | |
| 650 | 4 | |a Colorectal Surgery | |
| 650 | 4 | |a Colorectal neoplasms | |
| 650 | 4 | |a Crohn Disease | |
| 650 | 4 | |a Inflammatory Bowel Diseases | |
| 650 | 4 | |a Inflammatory Bowel Diseases |x surgery | |
| 650 | 4 | |a Inflammatory bowel diseases | |
| 700 | 1 | |a Farraye, Francis A. |e Sonstige |4 oth | |
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Datensatz im Suchindex
| _version_ | 1804135639172513792 |
|---|---|
| adam_text | Dysplasia and Cancer in Inflammatory
Bowel Disease
CONTENTS VOLUME 35 » NUMBER 3 « SEPTEMBER 2006
Preface xi
Francis A. Farraye
Epidemiology and Risk Factors for Colorectal
Dysplasia and Cancer in Ulcerative Colitis 517
Edward V. Loftus, Jr
Patients with ulcerative colitis (UC) are at increased risk of colorectal
cancer (CRC), but a series of population based studies published within
the past 5 years suggest that this risk has decreased over time. The
crude annual incidence rate of CRC in UC ranges from approximately
1 in 500 to 1 in 1600. In some cohorts, an elevated risk of CRC relative
to the general population can no longer be demonstrated. The exact
mechanism for this decrease in risk remains unclear but may be
attributable to a combination of more widespread use of maintenance
therapy and surveillance colonoscopy as well as more judicious reliance
on colectomy. In addition to the classic risk factors of increased extent
and duration of UC, it seems that primary sderosing cholangitis,
a family history of sporadic CRC, severity of histologic bowel
inflammation, and young age at colitis onset are independent risk
factors for cancer.
Pathology of Dysplasia and Cancer in Inflammatory
Bowel Disease 533
Robert D. Odze
Morphologic identification of dysplasia in mucosal biopsies is the best
and most reliable marker of an increased risk for malignancy in
patients who have inflammatory bowel disease, and it forms the basis
of the recommended endoscopic surveillance strategies that are in
practice for patients who have this illness. In ulcerative colitis (UC)
and Crohn s disease (CD), dysplasia is defined as unequivocal
neoplastic epithelium that is confined to the basement membrane,
without invasion into the lamina propria. Unfortunately, unlike in
UC, only a few studies have evaluated the pathologic features and
biologic characteristics of dysplasia and carcinoma in CD specifically.
As a result, this article focuses mainly on the pathologic features,
adjunctive diagnostic methods, and differential diagnosis of dysplasia
inUC.
v
Molecular Biology of Dysplasia and Cancer in
Inflammatory Bowel Disease 553
Steven H. Itzkowitz
Colorectal cancer (CRC) develops from a dysplastic precursor lesion,
regardless of whether it arises sporadically, in the setting of high risk
hereditary conditions, or in the context of chronic inflammation like
inflammatory bowel disease (IBD). This review focuses on the molecular
alterations associated with CRC pathogenesis in IBD. Although none of
the molecular alterations to be discussed have yet been integrated into
clinical practice, there is potential for molecular diagnostics to enhance
the management of patients with long standing IBD.
Natural History and Management of Flat and
Polypoid Dysplasia in Inflammatory Bowel Disease 573
Charles N. Bernstein
Dysplasia can be a marker that cancer is already present or is coming in
the near future. Hence, physicians should not be cavalier in approach to
finding it or in approach once it is found, whether it is in flat mucosa or
raised mucosa. Low grade dysplasia should garner similar respect to
high grade dysplasia, if for no other reason than the difficulty that
expert pathologists have in distinguishing it with certainty from high
grade dysplasia. There is no sure way to reduce the likelihood that
dysplasia will arise in ulcerative colitis. Some investigators have
promoted the use of 5 ASA; however, there is no definitive evidence
that 5 ASA can reduce cancer incidence.
Surveillance for Cancer and Dysplasia in
Inflammatory Bowel Disease 581
David T. Rubin and Robert T. Kavitt
Colorectal cancer (CRC) remains a significant cause of mortality in
patients with inflammatory bowel disease (IBD). Although most of the
studies on the risk of CRC in IBD have been performed in patients with
ulcerative colitis (UC), there is convincing evidence that patients with
Crohn s disease (CD) have a similar risk of developing neoplasia.
Although the risk of cancer in IBD remains rare, the fact that it occurs
in the setting of known risk factors and at a younger age than non IBD
related colon cancer therefore warrants prevention strategies. Current
guidelines for prevention of cancer in IBD recommend routine
surveillance colonoscopies with random biopsies and consideration of
proctocolectomy if precancerous dysplasia is identified and confirmed.
Although this approach remains of good clinical rationale, the evidence
for its benefit is minimal or lacking. This article reviews the rationale
and evidence for such a practice and compares current guidelines.
vi
Chromoendoscopy and Other Novel
Imaging Techniques 605
Ralf Kiesslich and Markus F. Neurath
The newly developed high resolution and magnification endoscopes
offer features that allow more and new mucosal details to be seen. They
are commonly used in conjunction with chromoendoscopy. The analysis
of mucosal surface details is beginning to resemble histologic examina¬
tion. More accurate recognition of small flat and depressed neoplastic
lesions is possible. Endoscopic prediction of neoplastic and nonneo
plastic tissue is possible by analysis of surface architecture of the mucosa,
which influences the endoscopic management. For the diagnosis of flat
adenomas, chromoendoscopy should be a part of the endoscopist s
armamentarium. In inflammatory bowel disease, chromoendoscopy can
be used for patients with long standing UC to unmask flat intraepithelial
neoplasia and is likely to become the new standard method for
surveillance colonoscopy in the near future. The new detailed images
seen with magnifying chromoendoscopy are the beginning of a new era
in which advances in optical development, such as confocal endomicro
scopy, allow a unique look at detailed cellular structures.
Cancer in Crohn s Disease 621
Sonia Friedman
There has been a multitude of case reports, population studies, and
studies from inflammatory bowel disease referral centers that links
Crohn s disease to intestinal and extraintestinal cancers. There is good
evidence to support an increased risk for colorectal cancer and small
bowel adenocarcinoma. There is less evidence to support a link between
Crohn s disease and lymphomas, leukemias, and carcinoids. For the
cancers of the colon, small intestine, and of chronic perianal fistulas,
vigilance on the part of the physician is required. For lymphomas,
leukemias, and carcinoids, more studies are needed to better define an
association, if any, with Crohn s disease.
Surgical Approaches to Cancer in Patients Who Have
Inflammatory Bowel Disease 641
Arthur F. Stucchi, Cary B. Aarons, and James M. Becker
Inflammatory bowel disease (IBD) clearly increases the risk for
gastrointestinal (GI) malignancies, especially colorectal cancer (CRC).
Surgery remains the only effective treatment for IBD related CRC.
Although the surgical options for GI cancers can vary, the indications
for surgical intervention are similar for all patients who have IBD.
When the appropriate surgical technique is used in IBD related small
bowel, colon, or rectal cancer, along with neoadjuvant or adjuvant
chemotherapy when necessary, prognosis, function, and long term
outcomes generally are good. Although the prognosis following surgical
treatment for patients who have IBD related CRC is no worse than for
vii
those whose cancers arise sporadically, the outcomes remain poor for
patients who have both Crohn s disease and small bowel adenocarci
nomas, primarily because of their advanced stage at detection.
Chemoprevention: Risk Reduction with Medical
Therapy of Inflammatory Bowel Disease 675
Erick P. Chan and Gary R. Lichtenstein
One of the most promising and important approaches to decrease the
risk of colorectal carcinoma in patients with long standing inflammatory
bowel disease is chemoprevention. This strategy focuses on the primary
prevention of dysplasia and carcinoma through the regular administra¬
tion of medications. Although multiple agents have been investigated
for such a beneficial effect, the data remain mixed, and additional
studies are needed. This article reviews the current evidence supporting
or refuting a chemoprotective effect of existing and emerging therapies.
Systemic Treatment of Patients Who Have Colorectal
Cancer and Inflammatory Bowel Disease 713
Wolfram Goessling and Robert J. Mayer
Inflammatory bowel disease (IBD) is an acknowledged predisposing
factor for the development of intestinal and extraintestinal cancers. In
general, an increased risk for colorectal cancer exists for patients who
have both ulcerative colitis (UC) and Crohn s disease (CD). Small
bowel tumors are extremely rare in the general population, but their
incidence is enhanced 40 fold in patients who have CD. UC confers
a marginally increased risk for myeloid leukemia, whereas patients who
have CD may have a trend toward a higher incidence of lymphoma.
This article reviews the therapeutic options for the most common
malignant complication, colorectal carcinoma, as well as specific
recommendations regarding the impact of the underlying disease
upon the tolerance and efficacy of chemotherapy in these patients.
Index 729
viii
|
| adam_txt |
Dysplasia and Cancer in Inflammatory
Bowel Disease
CONTENTS VOLUME 35 » NUMBER 3 « SEPTEMBER 2006
Preface xi
Francis A. Farraye
Epidemiology and Risk Factors for Colorectal
Dysplasia and Cancer in Ulcerative Colitis 517
Edward V. Loftus, Jr
Patients with ulcerative colitis (UC) are at increased risk of colorectal
cancer (CRC), but a series of population based studies published within
the past 5 years suggest that this risk has decreased over time. The
crude annual incidence rate of CRC in UC ranges from approximately
1 in 500 to 1 in 1600. In some cohorts, an elevated risk of CRC relative
to the general population can no longer be demonstrated. The exact
mechanism for this decrease in risk remains unclear but may be
attributable to a combination of more widespread use of maintenance
therapy and surveillance colonoscopy as well as more judicious reliance
on colectomy. In addition to the classic risk factors of increased extent
and duration of UC, it seems that primary sderosing cholangitis,
a family history of sporadic CRC, severity of histologic bowel
inflammation, and young age at colitis onset are independent risk
factors for cancer.
Pathology of Dysplasia and Cancer in Inflammatory
Bowel Disease 533
Robert D. Odze
Morphologic identification of dysplasia in mucosal biopsies is the best
and most reliable marker of an increased risk for malignancy in
patients who have inflammatory bowel disease, and it forms the basis
of the recommended endoscopic surveillance strategies that are in
practice for patients who have this illness. In ulcerative colitis (UC)
and Crohn's disease (CD), dysplasia is defined as unequivocal
neoplastic epithelium that is confined to the basement membrane,
without invasion into the lamina propria. Unfortunately, unlike in
UC, only a few studies have evaluated the pathologic features and
biologic characteristics of dysplasia and carcinoma in CD specifically.
As a result, this article focuses mainly on the pathologic features,
adjunctive diagnostic methods, and differential diagnosis of dysplasia
inUC.
v
Molecular Biology of Dysplasia and Cancer in
Inflammatory Bowel Disease 553
Steven H. Itzkowitz
Colorectal cancer (CRC) develops from a dysplastic precursor lesion,
regardless of whether it arises sporadically, in the setting of high risk
hereditary conditions, or in the context of chronic inflammation like
inflammatory bowel disease (IBD). This review focuses on the molecular
alterations associated with CRC pathogenesis in IBD. Although none of
the molecular alterations to be discussed have yet been integrated into
clinical practice, there is potential for molecular diagnostics to enhance
the management of patients with long standing IBD.
Natural History and Management of Flat and
Polypoid Dysplasia in Inflammatory Bowel Disease 573
Charles N. Bernstein
Dysplasia can be a marker that cancer is already present or is coming in
the near future. Hence, physicians should not be cavalier in approach to
finding it or in approach once it is found, whether it is in flat mucosa or
raised mucosa. Low grade dysplasia should garner similar respect to
high grade dysplasia, if for no other reason than the difficulty that
expert pathologists have in distinguishing it with certainty from high
grade dysplasia. There is no sure way to reduce the likelihood that
dysplasia will arise in ulcerative colitis. Some investigators have
promoted the use of 5 ASA; however, there is no definitive evidence
that 5 ASA can reduce cancer incidence.
Surveillance for Cancer and Dysplasia in
Inflammatory Bowel Disease 581
David T. Rubin and Robert T. Kavitt
Colorectal cancer (CRC) remains a significant cause of mortality in
patients with inflammatory bowel disease (IBD). Although most of the
studies on the risk of CRC in IBD have been performed in patients with
ulcerative colitis (UC), there is convincing evidence that patients with
Crohn's disease (CD) have a similar risk of developing neoplasia.
Although the risk of cancer in IBD remains rare, the fact that it occurs
in the setting of known risk factors and at a younger age than non IBD
related colon cancer therefore warrants prevention strategies. Current
guidelines for prevention of cancer in IBD recommend routine
surveillance colonoscopies with random biopsies and consideration of
proctocolectomy if precancerous dysplasia is identified and confirmed.
Although this approach remains of good clinical rationale, the evidence
for its benefit is minimal or lacking. This article reviews the rationale
and evidence for such a practice and compares current guidelines.
vi
Chromoendoscopy and Other Novel
Imaging Techniques 605
Ralf Kiesslich and Markus F. Neurath
The newly developed high resolution and magnification endoscopes
offer features that allow more and new mucosal details to be seen. They
are commonly used in conjunction with chromoendoscopy. The analysis
of mucosal surface details is beginning to resemble histologic examina¬
tion. More accurate recognition of small flat and depressed neoplastic
lesions is possible. Endoscopic prediction of neoplastic and nonneo
plastic tissue is possible by analysis of surface architecture of the mucosa,
which influences the endoscopic management. For the diagnosis of flat
adenomas, chromoendoscopy should be a part of the endoscopist's
armamentarium. In inflammatory bowel disease, chromoendoscopy can
be used for patients with long standing UC to unmask flat intraepithelial
neoplasia and is likely to become the new standard method for
surveillance colonoscopy in the near future. The new detailed images
seen with magnifying chromoendoscopy are the beginning of a new era
in which advances in optical development, such as confocal endomicro
scopy, allow a unique look at detailed cellular structures.
Cancer in Crohn's Disease 621
Sonia Friedman
There has been a multitude of case reports, population studies, and
studies from inflammatory bowel disease referral centers that links
Crohn's disease to intestinal and extraintestinal cancers. There is good
evidence to support an increased risk for colorectal cancer and small
bowel adenocarcinoma. There is less evidence to support a link between
Crohn's disease and lymphomas, leukemias, and carcinoids. For the
cancers of the colon, small intestine, and of chronic perianal fistulas,
vigilance on the part of the physician is required. For lymphomas,
leukemias, and carcinoids, more studies are needed to better define an
association, if any, with Crohn's disease.
Surgical Approaches to Cancer in Patients Who Have
Inflammatory Bowel Disease 641
Arthur F. Stucchi, Cary B. Aarons, and James M. Becker
Inflammatory bowel disease (IBD) clearly increases the risk for
gastrointestinal (GI) malignancies, especially colorectal cancer (CRC).
Surgery remains the only effective treatment for IBD related CRC.
Although the surgical options for GI cancers can vary, the indications
for surgical intervention are similar for all patients who have IBD.
When the appropriate surgical technique is used in IBD related small
bowel, colon, or rectal cancer, along with neoadjuvant or adjuvant
chemotherapy when necessary, prognosis, function, and long term
outcomes generally are good. Although the prognosis following surgical
treatment for patients who have IBD related CRC is no worse than for
vii
those whose cancers arise sporadically, the outcomes remain poor for
patients who have both Crohn's disease and small bowel adenocarci
nomas, primarily because of their advanced stage at detection.
Chemoprevention: Risk Reduction with Medical
Therapy of Inflammatory Bowel Disease 675
Erick P. Chan and Gary R. Lichtenstein
One of the most promising and important approaches to decrease the
risk of colorectal carcinoma in patients with long standing inflammatory
bowel disease is chemoprevention. This strategy focuses on the primary
prevention of dysplasia and carcinoma through the regular administra¬
tion of medications. Although multiple agents have been investigated
for such a beneficial effect, the data remain mixed, and additional
studies are needed. This article reviews the current evidence supporting
or refuting a chemoprotective effect of existing and emerging therapies.
Systemic Treatment of Patients Who Have Colorectal
Cancer and Inflammatory Bowel Disease 713
Wolfram Goessling and Robert J. Mayer
Inflammatory bowel disease (IBD) is an acknowledged predisposing
factor for the development of intestinal and extraintestinal cancers. In
general, an increased risk for colorectal cancer exists for patients who
have both ulcerative colitis (UC) and Crohn's disease (CD). Small
bowel tumors are extremely rare in the general population, but their
incidence is enhanced 40 fold in patients who have CD. UC confers
a marginally increased risk for myeloid leukemia, whereas patients who
have CD may have a trend toward a higher incidence of lymphoma.
This article reviews the therapeutic options for the most common
malignant complication, colorectal carcinoma, as well as specific
recommendations regarding the impact of the underlying disease
upon the tolerance and efficacy of chemotherapy in these patients.
Index 729
viii |
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| isbn | 1416040153 |
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| physical | XIII S., S. 517 - 734 Ill., graph. Darst. |
| publishDate | 2006 |
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| series | Gastroenterology clinics of North America |
| series2 | Gastroenterology clinics of North America |
| spelling | Dysplasia and cancer in inflammatory bowel disease guest ed. Francis A. Farraye Philadelphia [u.a.] Saunders 2006 XIII S., S. 517 - 734 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Gastroenterology clinics of North America 35,3 Colitis, Ulcerative Colorectal Neoplasms Colorectal Surgery Colorectal neoplasms Crohn Disease Inflammatory Bowel Diseases Inflammatory Bowel Diseases surgery Inflammatory bowel diseases Farraye, Francis A. Sonstige oth Gastroenterology clinics of North America 35,3 (DE-604)BV000613725 35,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014984283&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Dysplasia and cancer in inflammatory bowel disease Gastroenterology clinics of North America Colitis, Ulcerative Colorectal Neoplasms Colorectal Surgery Colorectal neoplasms Crohn Disease Inflammatory Bowel Diseases Inflammatory Bowel Diseases surgery Inflammatory bowel diseases |
| title | Dysplasia and cancer in inflammatory bowel disease |
| title_auth | Dysplasia and cancer in inflammatory bowel disease |
| title_exact_search | Dysplasia and cancer in inflammatory bowel disease |
| title_exact_search_txtP | Dysplasia and cancer in inflammatory bowel disease |
| title_full | Dysplasia and cancer in inflammatory bowel disease guest ed. Francis A. Farraye |
| title_fullStr | Dysplasia and cancer in inflammatory bowel disease guest ed. Francis A. Farraye |
| title_full_unstemmed | Dysplasia and cancer in inflammatory bowel disease guest ed. Francis A. Farraye |
| title_short | Dysplasia and cancer in inflammatory bowel disease |
| title_sort | dysplasia and cancer in inflammatory bowel disease |
| topic | Colitis, Ulcerative Colorectal Neoplasms Colorectal Surgery Colorectal neoplasms Crohn Disease Inflammatory Bowel Diseases Inflammatory Bowel Diseases surgery Inflammatory bowel diseases |
| topic_facet | Colitis, Ulcerative Colorectal Neoplasms Colorectal Surgery Colorectal neoplasms Crohn Disease Inflammatory Bowel Diseases Inflammatory Bowel Diseases surgery Inflammatory bowel diseases |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014984283&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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