Clinical features and oncological outcomes of intestinal cancers associated with ulcerative colitis and Crohn’s disease

Noguchi, Tatsuki; Ishihara, Soichiro; Uchino, Motoi; Ikeuchi, Hiroki; Okabayashi, Koji; Futami, Kitaro; Tanaka, Shinji; Ohge, Hiroki; Nagahara, Hisashi; Watanabe, Kazuhiro; Itabashi, Michio; Okamoto, Kinya; Okita, Yoshiki; Mizushima, Tsunekazu; Mizuuchi, Yusuke; Yamada, Kazutaka; Shimada, Yasuhiro; Sato, Yu; Kimura, Hideaki; Takahashi, Ken­ichi; Hida, Koya; Kinugasa, Yusuke; Okuda, Jun; Daito, Koji; Koyama, Fumikazu; Ueno, Hideki; Yamamoto, Takayuki; Hanai, Tsunekazu; Maemoto, Atsuo; Oba, Koji; Ajioka, Yoichi; Sugihara, Kenichi

doi:10.1007/s00535-022-01927-y

Cited by 11 publications

(25 citation statements)

References 26 publications

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“…In Western countries, CD-CRC tends to be more left-sided, similar to the findings in Asia, but the incidence of right-sided tumor is higher than the incidence of sporadic CRC (6,8,(26)(27)(28)(29). In this study, 81.5% of CD-CRC cases were located in the anorectum, similar to other reports from Asia (21,22). A higher incidence of CD-RC has been observed in Asia compared with Western countries.…”

Section: Discussionsupporting

confidence: 92%

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

et al. 2023

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on behalf of the Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon and Rectum INTRODUCTION: Colorectal cancer (CRC) is one of the major life-threatening complications in patients with Crohn's disease (CD). Previous studies of CD-associated CRC (CD-CRC) have involved only small numbers of patients, and no large series have been reported from Asia. The aim of this study was to clarify the prognosis and clinicopathological features of CD-CRC compared with sporadic CRC. METHODS:A large nationwide database was used to identify patients with CD-CRC (n 5 233) and sporadic CRC (n 5 129,783) over a 40-year period, from 1980 to 2020. Five-year overall survival (OS), recurrence-free survival (RFS), and clinicopathological characteristics were investigated. The prognosis of CD-CRC was further evaluated in groups divided by colon cancer and anorectal cancer (RC). Multivariable Cox regression analysis was used to adjust for confounding by unbalanced covariables.

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Section: Discussionsupporting

confidence: 92%

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

et al. 2023

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“…The higher percentage of advanced cancer in patients with CD than patients with UC may suggest that regular surveillance was not effective in patients with CD or that physicians were less adherent to surveillance intervals. This is another issue that merits further elucidation; however, it has been suggested that regular surveillance in patients with CD with anorectal lesions who need inspection of the anus and transanal biopsy under anesthesia in some cases could be stressful for both the patient and the physician (18,34). According to our subgroup analysis, biologics were the only drugs that showed a significant association with a lower risk of advanced cancer, irrespective of the diagnostic procedure.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, early-stage cancer was defined as either dysplasia or pathological stage 0/I cancer and advanced-stage cancer was defined as pathological stage II/III/IV cancer. This definition is based on the previous report from our group that there is almost no difference in long-term prognosis between CD and UC in dysplasia and stage 0/I cancer, but there is a significant difference in stage II/III/IV cancer, suggesting a biological difference between them in advanced stages (18). For each drug, the association between its use and stage progression was investigated.…”

Section: Methodsmentioning

confidence: 99%

Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study

et al. 2022

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INTRODUCTION:The aim of this study was to evaluate the effect of biologics on the risk of advanced-stage inflammatory bowel disease (IBD)-associated intestinal cancer from a nationwide multicenter data set.METHODS:The medical records of patients with Crohn's disease (CD) and ulcerative colitis (UC) diagnosed with IBD-associated intestinal neoplasia (dysplasia or cancer) from 1983 to 2020 were included in this study. Therapeutic agents were classified into 3 types: biologics, 5-aminosalicylic acid, and immunomodulators. The pathological cancer stage was compared based on the drug used in both patients with CD and UC.RESULTS:In total, 1,042 patients (214 CD and 828 UC patients) were included. None of the drugs were significantly associated with cancer stage in the patients with CD. In the patients with UC, an advanced cancer stage was significantly associated with less use of biologics (early stage: 7.7% vs advanced stage: 2.0%, P < 0.001), 5-aminosalicylic acid, and immunomodulators. Biologic use was associated with a lower incidence of advanced-stage cancer in patients diagnosed by regular surveillance (biologics [−] 24.5% vs [+] 9.1%, P = 0.043), but this was not the case for the other drugs. Multivariate analysis showed that biologic use was significantly associated with a lower risk of advanced-stage disease (odds ratio = 0.111 [95% confidence interval, 0.034–0.356], P < 0.001).DISCUSSION:Biologic use was associated with a lower risk of advanced IBD-associated cancer in patients with UC but not with CD. The mechanism of cancer progression between UC and CD may be different and needs to be further investigated.

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“…Information on patients who had undergone upfront radical surgery for up to stage III colorectal cancer was extracted from the Japanese Society for Cancer of the Colon and Rectum (JSCCR) data on ulcerative colitis patients with gastrointestinal cancer or dysplasia between January 1983 and December 2020 and were treated at any of 43 participating hospitals 22 . Patients for whom there was no information on postoperative complications and those who underwent other types of surgery were excluded.…”

Section: Methodsmentioning

confidence: 99%

Postoperative complications and prognosis based on type of surgery in ulcerative colitis patients with colorectal cancer: A multicenter observational study of data from the Japanese Society for Cancer of the Colon and Rectum

Hoshino

Hida

Yoshida

et al. 2023

Annals of Gastroent Surgery

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Background: Patients with ulcerative colitis are reported to be at increased risk of colorectal cancer and are also at high risk of postoperative complications. However, the incidence of postoperative complications in these patients and how the type of surgery performed affects prognosis are not well understood. Methods: Data collected by the Japanese Society for Cancer of the Colon and Rectum on ulcerative colitis patients with colorectal cancer between January 1983 and December 2020 were analyzed according to whether total colorectal resection was performed with ileoanal anastomosis (IAA), ileoanal canal anastomosis (IACA), or permanent stoma creation. The incidence of postoperative complications and the prognosis for each surgical technique were investigated. Results:The incidence of overall complications was not significantly different among the IAA, IACA, and stoma groups (32.7%, 32.3%, and 37.7%, respectively; p = 0.510).The incidence of infectious complications was significantly higher in the stoma group (21.2%) than in the IAA (12.9%) and IACA (14.6%) groups (p = 0.048); however, the noninfectious complication rate was lower in the stoma group (13.7%) than in the IAA (21.1%) and IACA (16.2%) groups (p = 0.088). Five-year relapse-free survival was higher in patients without complications than in those with complications in the IACA group (92.8% vs. 75.2%; p = 0.041) and the stoma group (78.1% vs. 71.2%, p = 0.333) but not in the IAA group (90.3% vs. 90.0%, p = 0.888). Conclusion:The risks of infectious and noninfectious complications differed according to the type of surgical technique used. Postoperative complications worsened prognosis.

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Clinical features and oncological outcomes of intestinal cancers associated with ulcerative colitis and Crohn’s disease

Cited by 11 publications

References 26 publications

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

Crohn's Disease–Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study

Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study

Postoperative complications and prognosis based on type of surgery in ulcerative colitis patients with colorectal cancer: A multicenter observational study of data from the Japanese Society for Cancer of the Colon and Rectum

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