Abstract
Background
Cronkhite-Canada syndrome (CCS) is considered a relentlessly progressive disease with high mortality rates. Although disease understanding and treatment options have greatly improved, the prognosis from these advancements has not been well documented. This study aimed to evaluate treatment outcomes and overall survival of CCS.
Methods
Seventeen patients who were diagnosed and treated over a 20-year period at Mayo Clinic (Rochester, Minnesota) were included. Data were abstracted, which included clinical and endoscopic manifestations, treatment course, and survival outcomes.
Results
The median (interquartile range) duration of follow-up was 8.3 (3.7–15.8) years. All patients received an initial prednisone dose equivalence of 30–80 mg daily, and five patients required steroids at the time of the last follow-up. Twelve patients trialed thiopurine therapy, and ten patients continued with a thiopurine until the last follow-up. Fifteen patients achieved clinical complete remission, and eleven patients achieved endoscopic complete remission after pharmacotherapy initiation. Seven patients required gastrointestinal surgeries during their disease course. The 5-year overall survival was 93.3% (95% confidence interval (CI): 81.5–100%), and the 3-year relapse-free survival was 82.4% (95% CI: 66.1–100%).
Conclusion
The prognosis and overall survival of patients with CCS have markedly improved with advancement in disease understanding and therapies. Pharmacotherapy, including corticosteroids and immunomodulators, is effective in inducing and maintaining remission, and gastrointestinal surgery is commonly needed as an adjunct for managing CCS disease complications.
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References
Wang W, Shao Y, Zhao DH, Xue F et al (2022) Endoscopic and pathological characteristics of Cronkhite- Canada syndrome: a retrospective analysis of 76 cases. Turk J Gastroenterol 33(1):19–29
Sweetser S, Boardman LA (2012) Cronkhite-Canada syndrome: an acquired condition of gastrointestinal polyposis and dermatologic abnormalities. Gastroenterol Hepatol 8(3):201–203
Wu ZY, Sang LX, Chang B (2020) Cronkhite-Canada syndrome: from clinical features to treatment. Gastroenterol Rep 8(5):333–342
Daniel ES, Ludwig SL, Lewin KJ, Ruprecht RM et al (1982) The Cronkhite-Canada syndrome. An analysis of clinical and pathologic features and therapy in 55 patients. Medicine 61(5):293–309
Liu S, You Y, Ruan G, Zhou L et al (2020) The long-term clinical and endoscopic outcomes of Cronkhite–Canada syndrome. Clin Translat Gastroenterol 11(4):e00167
Sweetser S, Ahlquist DA, Osborn NK, Sanderson SO et al (2012) Clinicopathologic features and treatment outcomes in Cronkhite-Canada syndrome: support for autoimmunity. Dig Dis Sci 57(2):496–502
Watanabe C, Komoto S, Tomita K, Hokari R et al (2016) Endoscopic and clinical evaluation of treatment and prognosis of Cronkhite-Canada syndrome: a Japanese nationwide survey. J Gastroenterol 51(4):327–336
Douglas CP, Yang PF, Riordan SM, Wong SW (2020) Ileal intussusception and perforation associated with Cronkhite-Canada syndrome. ANZ J Surg 90(6):1194–1195
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Jonathan Tien Pham: study’s concept and design, acquisition of data, and drafting of manuscript. John Benjamin Kisiel: drafting and critical revision of manuscript. Seth Sweetser: study’s concept and design, drafting of manuscript, and critical revision of the manuscript for important intellectual content and supervision.
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Pham, J.T., Kisiel, J.B. & Sweetser, S. Cronkhite-Canada syndrome: treatment responses and improved overall survival. Int J Colorectal Dis 38, 39 (2023). https://doi.org/10.1007/s00384-023-04332-w
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DOI: https://doi.org/10.1007/s00384-023-04332-w