Colorectal cancer in Crohn’s colitis is associated with advanced tumor invasion and a poorer survival compared with ulcerative colitis: a retrospective dual-center study

Purpose Colorectal cancer is a well-recognized complication of inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s colitis (CC). In this study, we assess the clinico-pathological features and outcomes of patients with colorectal cancer from UC in comparison with CC. Method...

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Bibliographic Details
Published in:International journal of colorectal disease 2021-01, Vol.36 (1), p.141-150
Main Authors: Vetter, Leonie E., Merkel, Susanne, Bénard, Alan, Krautz, Christian, Brunner, Maximilian, Mittelstädt, Anke, Schlegel, Nicolas, Wiegering, Armin, Germer, Christoph-Thomas, Weber, Klaus, Grützmann, Robert, Weber, Georg F.
Format: Article
Language:English
Subjects:
Cancer
Cancer patients
Colitis
Colorectal cancer
Comparative analysis
Gastroenterology
Gastrointestinal diseases
Hepatology
Internal Medicine
Medicine
Medicine & Public Health
Oncology, Experimental
Original
Original Article
Patient outcomes
Proctology
Surgery
Tumors
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Summary:Purpose Colorectal cancer is a well-recognized complication of inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s colitis (CC). In this study, we assess the clinico-pathological features and outcomes of patients with colorectal cancer from UC in comparison with CC. Methods Data of all patients with colitis-associated cancer (CAC) who underwent surgery at Erlangen or Würzburg University Clinic between 1995 and 2015 were selected. Clinical, histopathological, and survival data were analyzed retrospectively. Results Of all 88 patients with CAC, 20 patients had Crohn’s colitis and 68 patients had ulcerative colitis. We observed a young median age at tumor diagnosis (49.5 years UC; 45.5 years CC, p  = 0.208) in both diseases and a long median disease duration before CAC (19 years UC; 18 years CC; p  = 0.840). Patients with CC suffered more often from rectal cancer (14 (70.0%) in CC; 23 (33.8%) in UC; p  = 0.005) and advanced tumor stages (8 (47.0%) pT4 in CC; 14 (25.0%) pT4/ypT4 in UC; p  = 0.008). Five-year overall survival rate was 39.3% for CC and 67.1% for UC ( p  = 0.009 for difference between the groups). Survival did not differ significantly between UC and CC in the multivariate analysis after correction for UICC tumor stage. Conclusion CAC in CC showed advanced tumor stages associated with reduced survival compared with CAC in UC. This may be explained by less intense surveillance in patients with CC leading to delayed cancer diagnosis.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-020-03726-4