Precancer and Carcinoma in Chronic Ulcerative Colitis

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Abstract
Sixty patients with chronic ulcerative colitis and carcinoma have been studied. The morphological features of the tumours and colonic mucosa were examined in 27 cases. The long-term outcome of the total material was estimated. The patient's age at which the carcinoma developed was low and the prognosis mostly unfavourable (5-year survival about 25%). The bad prognosis seems to be an expression of a specific tumour biology at that particular age rather than characteristic features of colitic carcinoma per se. since the histological features of the idiopathic colo-rectal carcinomas in patients at the same age arc very similar to the colitic carcinomas. Precancerous mucosal changes could be demonstrated in all cases except one. The occurrence of precancerous changes in a rectal biopsy seems to justify a prophylactic proctocolectomy, since these patients have a special risk of developing a colonic carcinoma.