Literature DB >> 23475629

Clinical outcome of IBD-associated versus sporadic colorectal cancer: a matched-pair analysis.

Bernhard W Renz1, Wolfgang E Thasler, Gerhard Preissler, Tobias Heide, Philippe N Khalil, Michael Mikhailov, Karl-Walter Jauch, Martin E Kreis, Markus Rentsch, Axel Kleespies.   

Abstract

PURPOSE: This study assesses the perioperative course and long-term survival of inflammatory bowel disease (IBD)-associated vs. sporadic colorectal cancer (IBD-CRC vs. SCRC) after elimination of known confounders.
METHODS: Between 1991 and 2007, n = 3,299 patients underwent surgery for CRC at our institution. Thirty-three IBD patients were identified and compared to 165 SCRC using a matched-pair analysis (1:5 scenario). As matching parameters were used: age, gender, Union Internationale Contre le Cancer (UICC) stage, site of primary lesion, and date of surgery. After univariate analysis of the perioperative course, a multivariate survival analysis (Cox) of all patients (n = 198) was performed.
RESULTS: Significant differences were shown for preoperative symptoms (p = 0.022), transfusion rate (p = 0.01), ileostomy construction rate (p = 0.001), total complication rate (p = 0.042), and hospital stay (15 vs. 11 days, p < 0.001). Local tumor recurrence was three times higher in IBD-CRC (p = 0.004), and the 5-year survival rate was lower (49 % vs. 67 %, p = 0.03). IBD, advanced UICC stage, and synchronous liver metastasis were identified as independent prognostic factors.
CONCLUSION: We demonstrate for the first time survival differences between IBD-CRC and SCRC after elimination of five known confounders. This might be caused by a difference in tumor biology resulting in a higher local recurrence rate in IBD-CRC.

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Year:  2013        PMID: 23475629     DOI: 10.1007/s11605-013-2171-z

Source DB:  PubMed          Journal:  J Gastrointest Surg        ISSN: 1091-255X            Impact factor:   3.452


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