Crohn's Disease & New Diagnosis of Colon Cancer Algorithm
- Define Colonic Disease Extent, Activity & Review Prior Colonoscopies
- Chromo Exam: Eval for Flat Dysplasia or Resectable/Non-Resectable Dysplasia in Remaining Colon
- Complete Appropriate Ca Staging
- Assess Perianal Disease Activity (MR Pelvis ± EUA)
- Consult CRS, Medical Oncology/Tumor Board, Gl Psych, Nutrition
Considerations for HC vs. IRA
• Hemicolectomy:
- ↑↑ absorptive capacity = improved QOL
- ↑↑ area of "at risk" to survey = ↑ risk metachronous lesion
- Requires long-term surveillance exams
• Ileorectal Anastomosis:
- Intact rectum = improved QOL
- ↑ rates intact fertility and sexual dysfunction vs IPAA
- Ease of surveillance exams
Risk of Metachronous Dysplasia/Cancer
• Up to 39% of pts with CRC may develop metachronous CA despite yearly exam
• Up to 46% of pts with dysplasia may have new dysplasia
• ≠ recurrence HC vs STC
• TPC eliminates risk of recurrence
Dr. Waseem Ahmed @Waseem_AhmedMD
#Crohns #Disease #Colon #Cancer #algorithm #management #treatment #ibd
