Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease

Background/Aims: A considerable number of patients with Crohn’s disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn’s disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasi...

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Published in:Gut and liver 2020-05, Vol.14 (3), p.331
Main Authors: Sung Bae Kim, Jae Hee Cheon, Jae Jun Park, Eun Soo Kim, Seong Woo Jeon, Sung-ae Jung, Dong Il Park, Chang Kyun Lee, Jong Pil Im, You Sun Kim, Hyun Soo Kim, Jun Lee, Chang Soo Eun, Jeong Mi Lee, Byung Ik Jang, Geom Seog Seo
Format: Article
Language:Korean
Subjects:
Crohn disease
Recurrence
Risk factors
Surgery
Thiopurine
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Summary:Background/Aims: A considerable number of patients with Crohn’s disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn’s disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients. Methods: Clinical data of 372 patients with Crohn’s disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed. Results: Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence. Conclusions: Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence. (Gut Liver 2020;14:331-337)
ISSN:1976-2283