Oncological outcomes of patients with inflammatory bowel disease undergoing segmental colonic resection for colorectal cancer and dysplasia: systematic review

Sep 21, 2026

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Systematic review evaluating surgical and oncological outcomes for patients with inflammatory bowel disease (IBD) undergoing segmental colonic resection for colorectal cancer (CRC) and dysplasia, compared with proctocolectomy. The review was registered in PROSPERO and conducted in line with PRISMA using database and grey-literature searches, with independent screening and extraction. Included retrospective observational studies, reporting oncological and postoperative outcomes, with assessment of study quality. Results summarize patient cohorts, missed synchronous cancers and high-grade dysplasia rates, metachronous cancer incidence over follow-up, metastasis patterns, and comparable perioperative outcomes between surgical groups.

LanguageEnglish

CategoryResearch & Report

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Pages4

Reading Time10 min

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Introduction

Methods

Results

BJS Open, 2024, zrae052 [https://doi.org/10.1093/bjsopen/zrae052](https://doi.org/10.1093/bjsopen/zrae052) Short Report Oncological outcomes of patients with inflammatory bowel disease undergoing segmental colonic resection for colorectal cancer and dysplasia: systematic review Amira Shamsiddinova1,2,* , Jennie Burch1, Mohammed Deputy1,2 , Christopher Rao2,4, Guy Worley1,2 , Harry Dean1,2, Siwan Thomas-Gibson1,3 and Omar Faiz1,2 1Department of Surgery and Gastroenterology, St Mark’s Hospital and Academic Institute, London, UK 2Department of Surgery and Cancer, Imperial College London, London, UK 3Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK 4Department of Colorectal Surgery, North Cumbria Integrated Care NHS Foundation Trust, Cumberland Infirmary, Carlisle, UK *Correspondence to: Amira Shamsiddinova, Department of Surgery, St Mark’s Hospital and Academic Institute, Central Middlesex Hospital, Acton Lane, London NW10 7NS, UK (e-mail: [as3305@ic.ac.uk](as3305@ic.ac.uk)) Presented as a poster presentation to the 18th Congress of the European Crohn’s and Colitis Organisation, Copenhagen, Denmark, March 2023, the Annual Meeting of the British Society of Gastroenterology, Liverpool, UK, June 2023, and the Annual Meeting of the Association of Coloproctology of Great Britain & Ireland, Manchester, UK, July 2023. Introduction Dysplasia in inflammatory bowel disease (IBD) is a premalignant precursor to colorectal cancer (CRC); however, literature reporting progression rates is of low quality1. International guidelines on neoplasia management recommend proctocolectomy for CRC, endoscopically unresectable dysplasia, non-visible high-grade dysplasia (HGD), and multifocal low-grade dysplasia2, with a recent trend towards segmental colorectal resections, evidenced by population studies reporting 40–70% of patients with IBD-associated CRC undergoing segmental colectomy3–5. The aim of this systematic review was to evaluate surgical and oncological outcomes of segmental colectomy compared with proctocolectomy for neoplasia in IBD to inform decision-making. Methods This systematic review was registered on 22 December 2021 in PROSPERO, the international prospective register of systematic reviews, with registration number CRD42021292891, and was conducted in accordance with the PRISMA guidelines (PRISMA checklist is available as Supplementary Material)6. This work did not require ethical approval. Relevant databases and grey literature were searched using a search strategy (Supplementary Methods) . COVIDENCE software was used for screening and data extraction, independently by two authors. Studies were included if they were in English, were published between 1990 and 2023, reported on IBD patients who underwent segmental colectomy for dysplasia or cancer, and reported oncological or postoperative outcomes. Systematic reviews and case reports were excluded. Study quality was assessed7. The primary outcomes for the review were oncological. Results Initial searches returned 3194 results; nine studies5 ,8–15 were included (Fig. 1) . All studies were retrospective and observational, including 4181 patients with outcomes of 3810 segmental resections and 371 proctocolectomies. A total of four studies8,9,11,13 compared segmental colectomy with proctocolectomy outcomes. Male patients and those with ulcerative colitis were over-represented (greater than 60%) . There was significant study heterogeneity (33 of 95 fields ‘no/unclear’ in quality assessment; see the Supplementary Results), including indication for surgery. The studies spanned 1977 to 2020. A total of three studies11,13,15 reported on ulcerative colitis, one study14 reported on Crohn’s disease, and most studies included all IBD subtypes (Tables S1, S2) . Studies reported low rates of missed synchronous cancers (0 .5–4. 5%) and HGD (1 .3–5. 8%)5 , 12–14. Rates of metachronous cancers and dysplastic lesions were 0–33% at

FAQs

What clinical question does the systematic review address?

It evaluates surgical and oncological outcomes of segmental colectomy compared with proctocolectomy for neoplasia in patients with IBD, to inform decision-making.

How were studies identified and selected?

The review was registered in PROSPERO, followed PRISMA guidance, searched relevant databases and grey literature, and used independent screening and data extraction by two authors; eligible studies reported outcomes after segmental colectomy for dysplasia or cancer.

What main outcome patterns are reported for cancer progression and postoperative results?

The review reports low rates of missed synchronous cancers and high-grade dysplasia, metachronous cancer and dysplastic lesion rates over median follow-up, and generally similar surgical outcomes such as hospital stay, postoperative complication rates, and readmission between segmental resection and proctocolectomy.

Sep 21, 2026

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