Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2017; 23(3): 472-477
Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.472
Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease
Ivan Kristo, Stefan Riss, Stanislaus Argeny, Svenja Maschke, Praminthra Chitsabesan, Anton Stift
Ivan Kristo, Stefan Riss, Stanislaus Argeny, Svenja Maschke, Anton Stift, Department of Surgery, Medical University of Vienna, 1090 Wien, Austria
Praminthra Chitsabesan, Department of Surgery, York Teaching Hospital, York YO31 8HE, United Kingdom
Author contributions: Kristo I, Riss S, Argeny S, Maschke S, Chitsabesan P and Stift A contributed to conception and design of the study; Data extraction was performed by Kristo I, Maschke S, Stift A and analyses were performed by Kristo I; all authors participated in interpretation of data, creation of the manuscript and approved the final version.
Institutional review board statement: The study was reviewed and approved by the institutional review board of the Medical University of Vienna.
Informed consent statement: Patients were not required to give informed consent due to the fact that the original dataset was anonymized and the design of this study is retrospective. Data were obtained after patients gave written consent to the surgical interventions.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The original dataset is available from the corresponding author ( Consent was not obtained but presented data are anonymized and risk of identification is very low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Stefan Riss, MD, PD, FRCS, Associate Professor, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Telephone: +43-1-4040056210 Fax: +43-1-404006932
Received: November 1, 2016
Peer-review started: November 2, 2016
First decision: November 21, 2016
Revised: December 7, 2016
Accepted: December 16, 2016
Article in press: December 19, 2016
Published online: January 21, 2017

To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease (CD).


In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control (UICC).


During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6 (1.2%) patients (4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43 (27-66) years and a median history of CD of 16 (7-36) years. Malignant lesions were found in the rectum (n = 4, 66.7%), descending colon (n = 1, 16.7%) and ileocolon (n = 1, 16.7%). According to the UICC classification two patients were stages as I (33.3%), whereas the other patients were classified as stage IIA (16.7%), stage IIIB (16.7%), stage IIIC (16.7%) and stage IV (16.7%), respectively. After a median follow-up of 2 (0.03-8) years only 1 patient is still alive.


The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum.

Keywords: Stenosis, Incidental, Colorectal, Crohn's disease, Cancer, Gastrointestinal

Core tip: Incidental colorectal cancer can be expected in 1.2% of patients operated on for stricturing Crohn's disease. Predominantly, malignant lesions were localized in the rectum and are associated with poor prognosis.