Outcome after surveillance of low-grade and indefinite dysplasia in patients with ulcerative colitis

Joel R. Pekow, Jeremy T. Hetzel, Jami A. Rothe, Stephen B. Hanauer, Jerrold R. Turner, John Hart, Amy Noffsinger, Dezheng Huo, David T. Rubin

Research output: Contribution to journalArticlepeer-review

70 Scopus citations

Abstract

Background: The management of low-grade (LGD) and indefi-nite dysplasia (IND) in patients with ulcerative colitis (UC) remains controversial, as outcomes after a diagnosis of LGD or IND in previous studies vary widely. Methods: All patients evaluated were from a single institution referral center who had a history of UC and a diagnosis of either LGD or IND between 1994 and 2008 as confirmed by 2 expert gastrointestinal (GI) pathologists. Data were collected by chart review of electronic and paper medical records. All patients who did not undergo a colectomy within 90 days of their dysplasia diagnosis were included in the final analysis. Hazard ratios for risk factors as well as incidence rates and Kaplan-Meier estimates were used to calculate the progression to high-grade dysplasia (HGD) or colorectal cancer (CRC). Results: Thirty-five patients were included in the analysis, of whom 2 patients with IND and 2 patients with LGD developed HGD or CRC over a mean duration of 49.8 months. In total, the incident rate for advanced neoplasia for all patients was 2.7 cases of HGD or CRC per 100 person-years at risk. For flat and polypoid LGD the incident rate of advanced neoplasia was 4.3 and 1.5 cases per 100 person-years at risk, respectively. Patients with primary sclerosing cholangitis (PSC) had an incident rate of 10.5 cases per 100 years of patient follow-up. Conclusions: We report a low rate of progression to HGD or CRC in patients who underwent surveillance for LGD or IND; polypoid dysplasia showed less risk of progression than flat dysplasia.

Original languageEnglish (US)
Pages (from-to)1352-1356
Number of pages5
JournalInflammatory bowel diseases
Volume16
Issue number8
DOIs
StatePublished - 2010

Keywords

  • Colorectal cancer
  • Dysplasia
  • Ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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