Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcet's disease

Abstract

BACKGROUND: To date there have been few studies regarding the efficacy of surgical treatment and related prognostic factors following intestinal resection in patients with intestinal Behcet's disease (BD). Here we investigated the long-term clinical outcomes and related prognostic factors after surgical treatment for intestinal BD.

METHODS: We reviewed the medical records of 72 patients with intestinal BD who underwent surgery between March 1986 and May 2010. Prognostic factors were identified by univariate analysis using the Kaplan-Meier method, the log-rank test, and multivariate analysis using Cox proportional hazards regression models.

RESULTS: Recurrence after surgical treatment was observed in 42 (58.3%) patients and reoperations were performed in 22 (30.6%) patients. The cumulative recurrence rates after surgical treatment were 29.2% at 2 years and 47.2% at 5 years; the cumulative reoperation rates were 12.5% at 2 years and 22.2% at 5 years. Multivariate analysis identified volcano-shaped ulcers, higher C-reactive protein (CRP) levels (≥ 4.4 mg/dL), and the presence of intestinal perforations detected by pathology as independent predictive factors for recurrence. Moreover, volcano-shaped ulcers, higher CRP levels (≥ 4.4 mg/dL), and a history of postoperative steroid therapy were independent predictive factors for reoperation.

CONCLUSIONS: According to the current study, volcano-shaped ulcers, higher CRP levels, a history of postoperative steroid therapy, and the presence of intestinal perforations detected by pathology were factors of a poor prognosis. Careful follow-up is required in surgical patients with these risk factors, who are at high risk for recurrence and reoperation.