Computed tomographic colonography is valuable for post-treatment evaluation and screening of hidden colorectal cancer in patients with cryptogenic pyogenic liver abscess

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Abstract

Background/Aims: It has been demonstrated that cryptogenic pyogenic liver abscess (PLA) is associated with colonic mucosal defect, especially colorectal cancer (CRC). Therefore, the screening of CRC in patients with cryptogenic PLA is important. This study was to investigate whether computed tomographic colonography (CTC) has value as a follow-up modality as well as CRC screening tool in patients with PLA. Methods: A retrospective evaluation of 109 patients with cryptogenic PLA who underwent CTC or colonoscopy for CRC screening between July 2005 and July 2012 was performed. The patients were divided into a CTC group (n = 68) and colonoscopy group (n = 41) after treatment of liver abscess, and compared concerning the detection rate of advanced neoplasia, consisting of advanced adenomas and invasive carcinomas. Patients with advanced polyps in CTC surveillance underwent subsequent colonoscopy. Results: Advanced colonic neoplasia was detected in 9 of the 68 patients (13.2%) in the CTC group and 8 of the 41 patients (19.5%) in the conventional colonoscopy group (p = 0.42). The treatment response of all abscess lesions was clearly visualized on CTC, with complete resolution in 17.6% (12/68) of patients. After adjustment for sex and pathogens, old age (≥65 years) was significantly associated with advanced neoplasia (OR 5.481; 95% CI 1.757-17.100; p = 0.03). Conclusion: CTC has a valuable dual role as a follow-up modality and in the screening of CRC in patients with cryptogenic PLA, particularly in elderly patients over 65 years of age.

Original languageEnglish
Pages (from-to)175-183
Number of pages9
JournalDigestion
Volume89
Issue number3
DOIs
StatePublished - Jun 2014

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Pyogenic Liver Abscess
Computed Tomographic Colonography
Colorectal Neoplasms
Colonoscopy
Therapeutics
Early Detection of Cancer
Neoplasms
Liver Abscess
Polyps
Adenoma
Abscess

Keywords

  • Advanced neoplasm
  • Colonoscopy
  • Colorectal cancer
  • Computed tomographic colonography
  • Pyogenic liver abscess

Cite this

@article{0f1c9ca4d3944a61be041758216bd89e,
title = "Computed tomographic colonography is valuable for post-treatment evaluation and screening of hidden colorectal cancer in patients with cryptogenic pyogenic liver abscess",
abstract = "Background/Aims: It has been demonstrated that cryptogenic pyogenic liver abscess (PLA) is associated with colonic mucosal defect, especially colorectal cancer (CRC). Therefore, the screening of CRC in patients with cryptogenic PLA is important. This study was to investigate whether computed tomographic colonography (CTC) has value as a follow-up modality as well as CRC screening tool in patients with PLA. Methods: A retrospective evaluation of 109 patients with cryptogenic PLA who underwent CTC or colonoscopy for CRC screening between July 2005 and July 2012 was performed. The patients were divided into a CTC group (n = 68) and colonoscopy group (n = 41) after treatment of liver abscess, and compared concerning the detection rate of advanced neoplasia, consisting of advanced adenomas and invasive carcinomas. Patients with advanced polyps in CTC surveillance underwent subsequent colonoscopy. Results: Advanced colonic neoplasia was detected in 9 of the 68 patients (13.2{\%}) in the CTC group and 8 of the 41 patients (19.5{\%}) in the conventional colonoscopy group (p = 0.42). The treatment response of all abscess lesions was clearly visualized on CTC, with complete resolution in 17.6{\%} (12/68) of patients. After adjustment for sex and pathogens, old age (≥65 years) was significantly associated with advanced neoplasia (OR 5.481; 95{\%} CI 1.757-17.100; p = 0.03). Conclusion: CTC has a valuable dual role as a follow-up modality and in the screening of CRC in patients with cryptogenic PLA, particularly in elderly patients over 65 years of age.",
keywords = "Advanced neoplasm, Colonoscopy, Colorectal cancer, Computed tomographic colonography, Pyogenic liver abscess",
author = "Jang, {Dong Kee} and Jeong, {Sook Hyang} and Lee, {Sang Hyub} and Minjong Lee and Jang, {Eun Sun} and Kim, {Jin Wook} and Hwang, {Jin Hyeok} and Ryu, {Ji Kon} and Kim, {Yong Tae} and Lee, {Yoon Jin} and Lee, {Kyoung Ho} and Kim, {Young Hoon}",
year = "2014",
month = "6",
doi = "10.1159/000356534",
language = "English",
volume = "89",
pages = "175--183",
journal = "Digestion",
issn = "0012-2823",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Computed tomographic colonography is valuable for post-treatment evaluation and screening of hidden colorectal cancer in patients with cryptogenic pyogenic liver abscess

AU - Jang, Dong Kee

AU - Jeong, Sook Hyang

AU - Lee, Sang Hyub

AU - Lee, Minjong

AU - Jang, Eun Sun

AU - Kim, Jin Wook

AU - Hwang, Jin Hyeok

AU - Ryu, Ji Kon

AU - Kim, Yong Tae

AU - Lee, Yoon Jin

AU - Lee, Kyoung Ho

AU - Kim, Young Hoon

PY - 2014/6

Y1 - 2014/6

N2 - Background/Aims: It has been demonstrated that cryptogenic pyogenic liver abscess (PLA) is associated with colonic mucosal defect, especially colorectal cancer (CRC). Therefore, the screening of CRC in patients with cryptogenic PLA is important. This study was to investigate whether computed tomographic colonography (CTC) has value as a follow-up modality as well as CRC screening tool in patients with PLA. Methods: A retrospective evaluation of 109 patients with cryptogenic PLA who underwent CTC or colonoscopy for CRC screening between July 2005 and July 2012 was performed. The patients were divided into a CTC group (n = 68) and colonoscopy group (n = 41) after treatment of liver abscess, and compared concerning the detection rate of advanced neoplasia, consisting of advanced adenomas and invasive carcinomas. Patients with advanced polyps in CTC surveillance underwent subsequent colonoscopy. Results: Advanced colonic neoplasia was detected in 9 of the 68 patients (13.2%) in the CTC group and 8 of the 41 patients (19.5%) in the conventional colonoscopy group (p = 0.42). The treatment response of all abscess lesions was clearly visualized on CTC, with complete resolution in 17.6% (12/68) of patients. After adjustment for sex and pathogens, old age (≥65 years) was significantly associated with advanced neoplasia (OR 5.481; 95% CI 1.757-17.100; p = 0.03). Conclusion: CTC has a valuable dual role as a follow-up modality and in the screening of CRC in patients with cryptogenic PLA, particularly in elderly patients over 65 years of age.

AB - Background/Aims: It has been demonstrated that cryptogenic pyogenic liver abscess (PLA) is associated with colonic mucosal defect, especially colorectal cancer (CRC). Therefore, the screening of CRC in patients with cryptogenic PLA is important. This study was to investigate whether computed tomographic colonography (CTC) has value as a follow-up modality as well as CRC screening tool in patients with PLA. Methods: A retrospective evaluation of 109 patients with cryptogenic PLA who underwent CTC or colonoscopy for CRC screening between July 2005 and July 2012 was performed. The patients were divided into a CTC group (n = 68) and colonoscopy group (n = 41) after treatment of liver abscess, and compared concerning the detection rate of advanced neoplasia, consisting of advanced adenomas and invasive carcinomas. Patients with advanced polyps in CTC surveillance underwent subsequent colonoscopy. Results: Advanced colonic neoplasia was detected in 9 of the 68 patients (13.2%) in the CTC group and 8 of the 41 patients (19.5%) in the conventional colonoscopy group (p = 0.42). The treatment response of all abscess lesions was clearly visualized on CTC, with complete resolution in 17.6% (12/68) of patients. After adjustment for sex and pathogens, old age (≥65 years) was significantly associated with advanced neoplasia (OR 5.481; 95% CI 1.757-17.100; p = 0.03). Conclusion: CTC has a valuable dual role as a follow-up modality and in the screening of CRC in patients with cryptogenic PLA, particularly in elderly patients over 65 years of age.

KW - Advanced neoplasm

KW - Colonoscopy

KW - Colorectal cancer

KW - Computed tomographic colonography

KW - Pyogenic liver abscess

UR - http://www.scopus.com/inward/record.url?scp=84897358784&partnerID=8YFLogxK

U2 - 10.1159/000356534

DO - 10.1159/000356534

M3 - Article

C2 - 24714400

AN - SCOPUS:84897358784

VL - 89

SP - 175

EP - 183

JO - Digestion

JF - Digestion

SN - 0012-2823

IS - 3

ER -