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Войти в исследования Perianal Fistulizing Crohn's Disease-Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Wong Serre-Yu, Rowan Cathy, Brockmans Elvira Diaz, Law Cindy C Y, Giselbrecht Elisabeth, Ang Celina, Khaitov Sergey, Sachar David, Polydorides Alexandros D, Winata Leon Shin-Han, Verstockt Bram, Spinelli Antonino, Rubin David T, Deepak Parakkal, McGovern Dermot P B, McDonald Benjamin D, Lung Phillip, Lundby Lilli, Lightner Amy L, Holubar Stefan D, Hanna Luke, Hamarth Carla, Geldof Jeroen, Dige Anders, Cohen Benjamin L, Carvello Michele, Bonifacio Cristiana, Bislenghi Gabriele, Behrenbruch Corina, Ballard David H, Altinmakas Emre, Sebastian Shaji, Tozer Phil, Hart Ailsa, Colombel Jean-Frederic
Аннотация
METHODS: We conducted a systematic review by standard methodology, using the Newcastle-Ottawa Scale quality assessment tool. We subsequently developed consensus statements using a Delphi consensus approach.
RESULTS: Of 561 articles identified, 110 were eligible, and 76 articles were included. The overall quality of evidence was low. The TOpClass consortium reached consensus on 6 structured statements addressing screening, risk assessment, and management of PFCD-associated anorectal and fistula cancers. Patients with long-standing (>10 years) PFCD should be considered at small but increased risk of developing perianal cancer, including squamous cell carcinoma of the anus and anorectal carcinoma. Risk factors for squamous cell carcinoma of the anus, notably human papilloma virus, should be considered. New, refractory, or progressive perianal symptoms should prompt evaluation for fistula cancer. There was no consensus on timing or frequency of screening in patients with asymptomatic perianal fistula. Multiple modalities may be required for diagnosis, including an examination under anesthesia with biopsy. Multidisciplinary team efforts were deemed central to the management of fistula cancers.
CONCLUSIONS: Inflammatory bowel disease clinicians should be aware of the risk of PFCD-associated anorectal and fistula cancers in all patients with PFCD. The TOpClass consortium consensus statements outlined herein offer guidance in managing this challenging scenario.