What question did this study set out to answer?

Identify clinical and histopathological predictors of endoscopic postoperative recurrence (ePOR) in Crohn's disease to enhance management.

January 23, 2026

P1133Prediction of Endoscopic Postoperative Recurrence in Crohn’s Disease: A Nationwide Multicenter Real-World Cohort from China

Puntos clave

Identify clinical and histopathological predictors of endoscopic postoperative recurrence (ePOR) in Crohn's disease to enhance management.
Nationwide multicenter cohort study of Crohn's disease patients after ileocolonic resection.
Assessment of ePOR after 6-12 months using Rutgeerts’ score.
Construction of a nomogram for predicting ePOR risk based on clinical and pathological data.
Among 389 patients, the overall ePOR rate was 24.9%.
Independent risk factors for ePOR included prior biologic exposure and low preoperative albumin levels.
Preoperative exclusive enteral nutrition and early postoperative biologic therapy reduced ePOR risk.
Moderate-to-severe lymphoplasmacytic infiltration and lymphangiectasia predicted higher ePOR risk.
A combined clinical-pathological model showed strong predictive performance with an AUROC of 0.829.

Resumen

Abstract Background Background P 0.001) and preoperative albumin 35 g/L (OR 2.095, 95% CI 1.160-3.785; P = 0.014). In contrast, preoperative EEN (OR 0.338, 95% CI 0.188-0.610, P 0.001) and early postoperative prophylactic biologic therapy (OR 0.503, 95% CI 0.304-0.832, P = 0.007) were associated with a reduced risk. Histopathological predictors included moderate-to-severe lymphoplasmacytic infiltration in the lamina propria (OR 4.924, 95% CI 2.028-11.957, P 0.001) and lymphangiectasia (OR 4.916, 95% CI 2.395-10.092, P 0.001). A prediction model integrating clinical and pathological variables (AUROC 0.829) outperformed the clinical-only model (AUROC 0.715, P = 0.001). Conclusion Conclusions: In the era of biologics and perioperative optimization, the 6-12-months ePOR rate in CD patients was 24.9%. A combined clinical-pathological model showed strong predictive performance, but external validation is warranted to confirm its clinical applicability. References: 1. Buisson A, Chevaux JB, Allen PB, Bommelaer G, Peyrin-Biroulet L. Review article: the natural history of postoperative Crohn’s disease recurrence. Aliment Pharmacol Ther. 2012;35(6):625-33 2. Nguyen GC, Loftus EJ, Hirano I et al. American Gastroenterological Association Institute Guideline on the Management of Crohn’s Disease After Surgical Resection. Gastroenterology. 2017;152(1):271-275 3. De Cruz P, Kamm MA, Hamilton AL et al. Crohn’s disease management after intestinal resection: a randomised trial. Lancet. 2015;385(9976):1406-17 Conflict of interest: Mr. Hu, Fan: No conflict of interest Huang, Zicheng: No conflict of interest Zhu, Liangru: No conflict of interest Cao, Qian: No conflict of interest Guo, Hong: No conflict of interest Fu, Yu: No conflict of interest Huang, Lingjie: No conflict of interest Xiang, Lingya: No conflict of interest Chao, Kang: No conflict of interest Wang, Chao: No conflict of interest Gao, Xiang: No conflict of interest Chen, Minhu: No conflict of interest

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