The Clinical Significance of Crohn Disease Activity at Resection Margins.

Setoodeh S, Liu L, Boukhar SA, Singal AG, Westerhoff M, Waljee AK, Ahmed T, Gopal P. The Clinical Significance of Crohn Disease Activity at Resection Margins. Archives of pathology & laboratory medicine. 2019 Apr 1; 143(4):505-509.

Related HSR&D Project(s)

• CDA 11-217 – Risk Stratification and Targeted Therapy for HELP Diseases in Veterans

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

CONTEXT.—: Conflicting data about the clinical significance of microscopic Crohn disease (CD) activity at resection margins have led to varying practice patterns for routine reporting by pathologists. OBJECTIVE.—: To characterize the association between active disease at resection margins with postoperative CD recurrence and time-to-recurrence in the era of anti-tumor necrosis factor therapy. DESIGN.—: We performed a multicenter retrospective cohort study of 101 consecutive CD bowel resections during 10 years. Margin slides were reviewed, and CD activity at the margins was graded as none, mild, moderate, or severe. The association between microscopic CD activity at the margin with postoperative recurrence and time-to-recurrence were evaluated with logistic regression and Cox regression analyses, respectively. RESULTS.—: Crohn disease activity at resection margins was reported in 43% of pathology reports. Resection margins had CD involvement in 39.6% of cases, 20 of which were classified as mild, 6 as moderate, and 12 with severe CD activity. Although patients with mild (odds ratio, 1.14; 95% CI, 0.40-3.20) and moderate to severe (odds ratio, 1.97; 95% CI, 0.62-6.35) activity were at increased risk of disease recurrence, the differences were not statistically significant. Patients with mild (hazard ratio, 0.97; 95% CI, 0.50-1.91) and moderate to severe (hazard ratio, 1.29; 95% CI, 0.65-2.55) disease activity at margins did not have significantly different time-to-recurrence compared with those without disease activity. CONCLUSIONS.—: Our study suggests CD activity at resection margins is not significantly associated with postoperative CD recurrence.