SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2010
Malignant transformation in perianal fistulas of Crohn's disease: a systematic review of literature.
Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Malignant Transformation of Perianal Fistulas: A Systematic Review of the Literature.Journal of surgical oncology · 2026Pooled it
- Perianal fistulizing Crohn's disease: Clinical practice update from Colitis and Crohn's Foundation (India).Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Guideline
- Perianal Mucinous Adenocarcinoma: A Case Report and a Systematic Review of the Literature.Journal of gastrointestinal cancer · 2024Pooled it
- Anorectal Cancer in Crohn's Disease Has a Poor Prognosis Due to its Advanced Stage and Aggressive Histological Features: a Systematic Literature Review of Japanese Patients.Journal of gastrointestinal cancer · 2020Pooled it
- Complete pathological response to neoadjuvant chemoradiotherapy in Crohn's disease-associated fistula adenocarcinoma: a case report.Frontiers in medicine · 2026Article
- Treatment and survival of non-metastatic rectal cancer in patients with inflammatory bowel disease: nationwide cohort study.BJS open · 2025Article
- "Budding"-an early MRI feature established in a case-control study of perianal fistula mucinous adenocarcinoma.Journal of gastrointestinal oncology · 2025Article
- Case report of squamous cell carcinoma secondary to recurrent anal fistula.Frontiers in oncology · 2025Article
- Establishment of a surveillance program for anal cancer in Crohn's disease.World journal of gastroenterology · 2024Article
- Machine learning‑based radiomics models accurately predict Crohn's disease‑related anorectal cancer.Oncology letters · 2024Article
- Perianal disease in inflammatory bowel disease: Broadening treatment and surveillance strategies for anal cancer.World journal of gastroenterology · 2024Review
- Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023.Intestinal research · 2024Article
- Cancer in Anal Fistulas.Clinics in colon and rectal surgery · 2024Review
- Beyond squamous cell carcinoma: MRI appearance of uncommon anal neoplasms and mimickers.Abdominal radiology (New York) · 2023Review
- Fistula-Associated Anal Adenocarcinoma: A 20-Year Single-Center Experience.Annals of surgical oncology · 2023Article
- The Role of Inflammation in Anal Cancer.Diseases (Basel, Switzerland) · 2022Review
- Anorectal Strictures in Complex Perianal CD: How to Approach?Clinics in colon and rectal surgery · 2022Review
- Chemoradiotherapy for fistula-related perianal squamous cell carcinoma with Crohn's disease.International cancer conference journal · 2021Article
- Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy.Annals of coloproctology · 2021Article
- Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMalignant transformation of perineal fistula in Crohn's disease has rarely been reported. The aim of this study is to define the patient's characteristics and clinical presentation of this rare disease.
methodsA systematic review of case series and reports published in English language between 1950 and 2008 was conducted. All cases with malignancy in low pelvic/perineal fistula in patients with Crohn's disease were included. All selected cases were then analyzed with respect to age, gender, duration of Crohn's disease and fistula, location of fistula, presenting symptoms, method of diagnosis, delay in diagnosis, histopathology, treatment, and outcome. Data analyses were done using chi-squared or Fisher's exact test and the Mann-Whitney test.
resultsLiterature review revealed 61 cases of carcinomas arising in perineal fistulas in Crohn's disease. Sixty-one percent (37) of the patients were females. Females were significantly younger than males at the time of diagnosis of cancer (47 vs. 53 years, P < 0.032). Males were also noted to have significantly longer duration of Crohn's disease compared to females (24 vs. 18 years, P = 0.005). However, females were noted to have the fistula for significantly shorter duration prior to cancer transformation when compared to males (8.3 vs. 16 years, P = 0.0035). On initial examination, malignancy was suspected and proven only in 20% of patients (n = 12). Adenocarcinoma was the most common histology (59%, n = 36), followed by squamous cell carcinoma (31%, n = 19). In most patients (59%, n = 36), the fistula was rectal in origin.
conclusionsA high suspicion for malignancy in chronic perineal fistulas associated with Crohn's disease should be maintained in spite of negative biopsies. Especially in women, the shorter duration of Crohn's fistulas prior to malignant degeneration necessitates an aggressive approach to rule out cancer.
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