- Colorectal cancer secondary to ulcerative colitis (UC) is more likely to feature lymph node involvement (N+) in patients who have cancer in the left colon, who have colonic strictures, or who are younger at surgery.
- Risk factors identified in current screening guidelines (duration, extension, and severity of disease) are not associated with N+.
Why this matters
- Current screening guidelines are not adequate for identifying patients with UC prone to early-onset cancer or those diagnosed with lymph node involvement at surgery despite surveillance.
- Researchers studied the health records of patients who underwent curative surgery for UC (N=130; 60.8% men; median age at diagnosis, 28 years; age range, 9-73 years), comparing those who were N+ with N− control patients.
- Funding: None.
- 30.8% (n=40) of patients were N+ at surgery.
- Median age of these patients was significantly lower than that of N− patients (47 vs 54 years; P=.036).
- Other factors associated with N+ risk included:
- Left colon location (OR, 2.44; P=.045).
- Colonic stricture (OR, 5.07; P=.002).
- The study was retrospective, and surveillance history for each patient was limited to the last 2 colonoscopies.