Preoperative Predictors of Neoplasia in Patients Undergoing Small Bowel Resection for Complicated Crohn's Disease: A Multicentre Case-Control Study.

Capucine Chappe (1) , Cecile Salut (2) , Aurelien Amiot (3) , Delphine Gaye (4) , Nora Frulio (2) , Bruno Lapuyade (5) , Lucine Vuitton (6) , Romain Altwegg (7) , Cyrielle Gilletta (8) , Mathurin Fumery (9, 10) , Guillaume Bouguen (11, 12, 13) , Melanie Serrero (14) , Maria Nachury (15) , Nicolas de Suray , Ludovic Caillo (16) , Mireille Simon (17) , David Laharie (5) , Pauline Rivière , Florian Poullenot (5)

1 UB - Université de Bordeaux
2 Hôpital Saint-André
3 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
4 Hôpital Haut-Lévêque [CHU Bordeaux]
5 CHU Bordeaux
6 Service de Gastro-Entérologie [CHRU Besançon]
7 CHRU Montpellier - Hôpital Saint Eloi
8 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
9 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
10 CHU Amiens-Picardie
11 NuMeCan - Nutrition, Métabolismes et Cancer
12 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
13 CIC - Centre d'Investigation Clinique [Rennes]
14 Hôpital Nord [CHU - APHM]
15 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
16 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
17 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]

Crohn's disease (CD) is associated with an increased risk of small bowel neoplasia (SBN). We aimed to assess preoperative predictors of SBN in CD patients. We conducted a retrospective case-control study including CD patients who underwent surgery: cases were diagnosed with SBN on histopathological analysis and controls had no neoplasia. Preoperative cross-sectional imaging was reviewed by a panel of blinded expert radiologists. Fifty cases were matched to one hundred and fifty consecutive controls. In multivariable analysis, predictors of SBN were age ≥ 50 years (OR = 28, 95% CI = 5.05-206), median CD duration ≥ 17.5 years (OR = 4.25, 95% CI = 1.33-14.3), and surgery for stricture (OR = 5.84, 95% CI = 1.27-35.4). The predictors of small bowel adenocarcinoma were age ≥ 50 years (OR = 5.14, 95% CI = 2.12-12.7), CD duration ≥ 15 years (OR = 5.65, 95% CI = 2.33-14.3), and digestive wall thickening > 8 mm (OR = 3.79, 95% CI = 1.45-11.3). A predictive score based on the aforementioned factors was constructed. Almost 73.7% of patients with a high score had SBA. Old age, long small bowel CD duration, and stricture predicted the presence of SBN, particularly adenocarcinoma when patients have digestive wall thickening > 8 mm on preoperative imaging.

Mots clés: Crohn’s disease; predictive factors; small bowel adenocarcinoma; small bowel neoplasia

Domaines: Médecine humaine et pathologie

Capucine Chappe, Cecile Salut, Aurelien Amiot, Delphine Gaye, Nora Frulio, et al.. Preoperative Predictors of Neoplasia in Patients Undergoing Small Bowel Resection for Complicated Crohn's Disease: A Multicentre Case-Control Study.. Cancers, 2023, 15 (7), ⟨10.3390/cancers15072004⟩. ⟨hal-04076226⟩