AG

AA

bst

ract

sSu1047

Usefulness of Preoperative Chest CT in Staging of Colon Cancer WithoutLiver MetastasisHye Young Kim, Gil Sun Lee, Limwha Song, Dong Kyung Chang, Jin Yong Kim, Jae JKim, Young-Ho Kim, Jong Chul Rhee

Purpose: Preoperative staging with chest computed tomography (CT) is recommended incolon cancer patients. However, there have been only scant data on examining the clinicalefficacy of preoperative chest CT. The aim of this study was to evaluate the efficacy ofpreoperative chest CT in colon cancer patients without liver metastasis. The incidence oflung metastasis found by chest CT in those who had negative findings on initial chest X-ray and the risk factors for such metastasis were evaluated. Methods: Preoperative stagingchest CT has been performed in every patients with colon cancer at Samsung Medical Centersince January 2008. 320 colon cancer patients without liver metastasis were retrospectivelyreviewed and analyzed. Patients enrolledwere thosewho had negative findings in preoperativechest X-ray and had undergone surgery for colon cancer during the period January 2008to April 2010. Patients with rectal cancer were excluded. The mean follow up period was20.5 months (0.2-32.2months). Results: Lung nodule on chest CT was found in 137 patients(42.8%). 18 of those were definitely diagnosed as lung metastasis (5.6%), and 2 of thoseas lung cancer (0.6%) by follow up chest CT or pathologic confirmation. There were nocases of delay in surgery due to findings of lung nodule. The mean period to definitediagnosis of lung nodule was 7.9months (0-25months). Comparing the group with lungmetastasis to that without lung metastasis, group with lung metastasis was found to besignificantly female predominant (p=0.021), and more patients in this group had elevatedlevel of CA19-9 (p=0.046). Furthermore, postoperative pathologic findings reported moreadvanced T, N status (p=0.007, p=0.000, respectively ) and lymphatic invasions (p=0.004)in this group. More advanced T or N status was also suspected on the preoperative abdominalCT (p=0.034, p=0.016,respectively ). Multivariate analysis showed lymph node metastasisas the risk factor of lung metastasis in colon cancer patients. Conclusions: The incidenceof lung metastasis found by chest CT was 5.6% in colon cancer patients without livermetastasis who had negative findings on initial chest X-ray films. We conclude that stagingchest CT can be beneficial to colon cancer patients with lymph node metastasis.

Su1048

Tracking of Height and Body Mass Index (BMI) in Pediatric InflammatoryBowel Disease: A 15-Year Population-Based StudySeema Mehta, Hoda M. Malaty, Elizabeth A. Garnett, Bincy P. Abraham, CarolynThibodeaux, George D. Ferry

Objective: Growth impairment is a major complication of pediatric inflammatory boweldisease (IBD). We aim to characterize growth pattern in this population at initial presentationand maximal follow-up. Methods: We completed a retrospective study on pediatric IBDpatients at Texas Children's Hospital from 1986-2003. Children with no or <1yr follow-upwere excluded. Z-score of BMI/age and height (ht)/age were calculated. The change in BMIand ht. Z-scores from initial to final visit were assessed. T-test and paired T-test were appliedto compare the BMI and ht. Z-scores. Results: We identified 207 patients, 127 had Crohn'sDisease (CD), 58 had ulcerative colitis (UC), and 22 had inderterminate colitis (IC). Maleto female ratio was 1.3:1. The mean age at the initial visit was 11.4+3.4yr and at the finalvisit was 15.1+3.4yr. The median follow-up was 3.7yr. At the initial visit, 3.9% (n=5) ofCD, 8.6% (n=5) of UC, and 4.6% (n=1) of IC patients had a ht. Z-score less than -2sd. Atthe final visit, 4.7% (n=6) of CD, 6.9% (n=4) of UC, and 9.1% (n=2) of IC pts. had a ht.Z-score less than -2sd. Ht. and BMI were impaired at the initial visit in CD vs. UC/ICpatients (BMI: -0.47±1.49 vs. 0.18±1.34, p=0.002; Ht: -0.48±0.95 vs. -0.12±1.25, p=0.02).When comparing CD to UC patients alone, the differences were not significant (BMI:-0.47±1.49 vs. -0.04±1.43, p=0.07; Ht: -0.48±0.95 vs. -0.17±1.12, p=0.06). At the finalvisit, the mean ht. Z-score did not significantly improve for UC or IC, and for CD patientsit decreased (-0.38±1.01 vs. -0.48±0.95, p=0.197). BMI Z-score improved for CD but wasstill less than UC/IC pts. (0.13±1.11 vs. 0.47±1.10, p=0.034). The BMI difference was notsignificant for CD vs. UC patients at the final visit (0.13±1.11 vs. 0.31±1.14, p=0.314). Theoverall difference in ht. did not improve for all patients from the initial to final visit (-0.34±0.97 vs. -0.42±0.99, p=0.11). The overall difference in BMI improved (-0.18±1.44 vs.0.27±1.11, p=0.000). IC patients demonstrated the greatest difference in BMI from initialto final visit followed by CD and then UC patients (-0.50±1.15 vs. -0.48±1.08 vs. -0.45±1.01).All differences were significant, p=0.000. Males had a lower BMI at initial (-0.39±1.46 vs.0.01±1.45, M vs. F, respectively) and final visits (0.06±1.19 vs. 0.52±0.96). Conclusion:At their initial visit, children with CD have more significant deficits in height and BMI thanthose with UC and IC. While the overall difference in BMI improved for all patients fromthe initial to final visit, height did not significantly improve and slightly deteriorated forchildren with CD. BMI should be interpreted in the context of additional growth parameters,particularly height. With the introduction of biologic therapy, studies investigating its effecton growth in pediatric IBD patients are needed.

Su1049

Evaluation of Safety Trial of High-Intensity Focused Ultrasound Therapy forPancreatic CancerAtsushi Sofuni, Fuminori Moriyasu, Takatomo Sano, Kota Yamada, Fumihide Itokawa,Takayoshi Tsuchiya, Toshio Kurihara, Shujiro Tsuji, Kentaro Ishii, Nobuhito Ikeuchi,Junko Umeda, Reina Tanaka, Takao Itoi

INTRODUCTION/OBJECTIVES: Even with recent advances in the diagnostic image techno-logy, most cases of pancreatic cancer are founded at an unresectable stage.The results ofchemotherapy and chemo-radiotherapy for the condition were not been satisfactory. There-fore, new advances in therapy are expected. Recently, the ultrasound technology has beendeveloped to the use of focused ultrasound energy for therapeutic intention such as tissueablation. AIMS & METHODS: High-intensity focused ultrasound (HIFU) is being promotedas a method to ablate the tumor and achieve relief of pain in unresectable pancreatic cancer.

S-392AGA Abstracts

HIFU therapy is regarded as minimally invasive or noninvasive therapy unlike some sideeffects of radiofrequency therapy. Therefore, HIFU is regarded to be possible to be combinedwith chemotherapy as the minimally invasive combination therapy and pain control inunresectable pancreatic cancer. We first evaluated the safety of HIFU therapy for unresectablepancreatic cancer. We have performed HIFU therapy for unresectable pancreatic cancer asoptional local therapy as well as systemic chemotherapy for patients, with whom an agreementwas obtained in adequate IC, from the end of 2008 in our hospital. This treatment studytook approval of member of ethic society of our hospital. The HIFU device used is FEP-BY02 (China Medical Technologies Co.LTD., China). The subjects were 12 unresectablepancreatic cancers, i.e. 1 case in stage II, 5 cases in stage III, 6 cases in stage IV. RESULTS:All pancreatic tumors were visualized by HIFU ultrasound monitor system, and the tumorlocations could be fixed. They were treated under the visualization. The treatment data wasfollowed; mean tumor size: 32.5 (15-40) mm, mean treatment sessions: 2.6 (1-4) times,mean total treatment time: 2.6 (1-4.5) hours. Treatment Parameters were followed; meantransmission power: 500-1000W, mean frequency of pulse/spot: 500-2000, transmissiontime (T1): 150-1000ms, and interval time (T2): 150-3000ms. There was no sedation for allpatients. We arranged the transmission power, spot, transmission time, and interval time,when the patients appeal the frizzy and blunt pain. Complications were not found exceptone pancreatic pseudo cyst and 2 mild skin burns. No pancreatitis and intestinal perforation.Complete tumor ablation rate was 73%, and the effect of relief of pain was 64%. CONCLU-SION: We suggested the safety and present actions for treatment of HIFU that aimed at animprovement of therapeutic result for unresectable pancreatic cancer.

Su1050

Is Iron Deficiency in the Absence of Anemia Associated With Fatigue in IBD?Benjamin A. Goldenberg, Lesley A. Graff, Ian Clara, John R. Walker, Rachel Carr, LindaRogala, Norine Miller, Patricia E. Rawsthorne, Charles N. Bernstein

Background: It is commonly believed that iron deficiency causes fatigue. While this seemslogical when iron deficiency results in anemia, it is unknown if iron deficiency in the absenceof anemia is associated with fatigue. Methods: 318 participants in the population-basedManitoba IBD Cohort Study (Crohn's disease, (CD) 51%) had concurrent assessment offerritin and hemoglobin by blood draw, disease activity through clinically administeredindices (Harvery Bradshaw Index-HBI for CD; Powell Tuck-PT for UC) and fatigue basedon a validated self-report measure (Multidimensional Fatigue Inventory-MFI), High fatiguewas defined as scoring > 95th percentile in a healthy sample. Iron deficiency was defineda priori as ferritin <20 ug/L; low iron was defined as ferritin 20-39 ug/l, to account forpotentially higher but relevant ferritin levels in the context of iron deficiency and inflamma-tion. Results: 16% with CD (n=25) were iron deficient; of those, over half had no anemia(n=14). Similarly, 19% with UC (n=30) were iron deficient, and 63% of those had no anemia(n=19). 5 did not complete the MFI. See table for data on comparison between those withno and high fatigue by iron status. 17% of the total sample with inactive IBD (n=26 of 153)were iron deficient; only 10 of these had high fatigue compared to 16 with no fatigue. 61of these 153 with inactive IBD had low iron, with 16 experiencing high fatigue and 45experiencing no fatigue. Overall, there was no correlation between ferritin levels and fatiguelevels ( r= -0.01), and there was no correlation with ferritin levels and disease activity (0.13with HBI, -0.05 for PT). Conclusion: In this community-based IBD sample, there was noevidence of an association between iron deficiency (ferritin <20 ug/L) and fatigue. The lackof relationship held for a more liberal definition of iron deficiency (ferritin <40 ug/L) as well.Comparison of those with and without fatigue for iron deficiency

Inactive IBD =HBI or PT <5

Su1051

A Prospective Case - Control Pilot Study About the Relationship BetweenColorectal Polyps and Angiotensin Receptor Blockers and Angiotensin-Converting Enzime InhibitorGuillermo Nicolás Panigadi, Lisandro Pereyra, José M. Mella, Raquel González, CarolinaFischer, Pablo Luna, Alejandro Canelas, Maximiliano Bun, Nicolas A. Rotholtz, Silvia C.Pedreira, Daniel G. Cimmino, Luis A. Boerr

Introduction: Angiotensin-receptor blockers (ARBs) and angiotensin-converting enzymeinhibitors(ACEI) are widely used drugs. The renin-angiotensin system has been related withangiogenesis and tumor progression. The association of these drugs with colorectal polypshas not described. Aim: To determine the risk of colonic polyps in patients under ARBs orACE inhibitors treatment. Materials and methods: A prospective case control study wasconducted in a private community hospital in Argentina from August to November 2010.Patients scheduled for an outpatient colonoscopy during this period were included, andwere asked to complete a survey with information about their behavioral factors (diet,exercise and smoking), disease history (diabetes, obesity, dislipemia and hypertension),medications (hypolipemiant, antihypertensive and non-steroidal anti-inflammatory drugs)and personal and family history of colorectal neoplasia. In those patients under ARBs orACEI treatment, type and treatment duration was also consigned. Patients who were under