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

Takayuki Ogino; Tsunekazu Mizushima; Makoto Fujii; Yuki Sekido; Hidetoshi Eguchi; Riichiro Nezu; Hiroki Ikeuchi; Uchino Motoi; Kitaro Futami; Kinya Okamoto; Hisashi Nagahara; Kazuhiro Watanabe; Koji Okabayashi; Kazutaka Yamada; Hiroki Ohge; Shinji Tanaka; Yusuke Mizuuchi; Yoshiki Ohkita; Yu Sato; Hideki Ueno; Toru Kono; Michio Itabashi; Hideaki Kimura; Koya Hida; Yusuke Kinugasa; Kenichi Takahashi; Fumikazu Koyama; Tsunekazu Hanai; Kiyoshi Maeda; Toshihiro Noake; Yoshifumi Shimada; Takayuki Yamamoto; Junya Arakaki; Keiji Mastuda; Junji Okuda; Eiji Sunami; Yoshito Akagi; Kenji Kastumata; Kay Uehara; Takeshi Yamada; Shin Sasaki; Soichiro Ishihara; Yoichi Ajioka; Kenichi Sugihara

doi:10.14309/ajg.0000000000002269

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

Takayuki Ogino, Tsunekazu Mizushima, Makoto Fujii, Yuki Sekido, Hidetoshi Eguchi, Riichiro Nezu, Hiroki Ikeuchi, Uchino Motoi, Kitaro Futami, Kinya Okamoto, Hisashi Nagahara, Kazuhiro Watanabe, Koji Okabayashi, Kazutaka Yamada, Hiroki Ohge, Shinji Tanaka, Yusuke Mizuuchi, Yoshiki Ohkita, Yu Sato, Hideki UenoToru Kono, Michio Itabashi, Hideaki Kimura, Koya Hida, Yusuke Kinugasa, Kenichi Takahashi, Fumikazu Koyama, Tsunekazu Hanai, Kiyoshi Maeda, Toshihiro Noake, Yoshifumi Shimada, Takayuki Yamamoto, Junya Arakaki, Keiji Mastuda, Junji Okuda, Eiji Sunami, Yoshito Akagi, Kenji Kastumata, Kay Uehara, Takeshi Yamada, Shin Sasaki, Soichiro Ishihara, Yoichi Ajioka, Kenichi Sugihara

Advanced Robotic and Endoscopic Surgery

Research output: Contribution to journal › Article › peer-review

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Abstract

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 = 233) and sporadic CRC (n = 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.RESULTS:Compared with sporadic cases, patients with CD-CRC were younger; more often had RC, multiple lesions, and mucinous adenocarcinoma; and had lower R0 resection rates. Five-year OS was worse for CD-CRC than for sporadic CRC (53.99% vs 71.17%, P < 0.001). Multivariable Cox regression analysis revealed that CD was associated with significantly poorer survival (hazard ratio 2.36, 95% confidence interval: 1.54-3.62, P < 0.0001). Evaluation by tumor location showed significantly worse 5-year OS and RFS of CD-RC compared with sporadic RC. Recurrence was identified in 39.57% of CD-RC cases and was mostly local.DISCUSSION:Poor prognosis of CD-CRC is attributable primarily to RC and high local recurrence. Local control is indispensable to improving prognosis.

Original language	English
Pages (from-to)	1626-1637
Number of pages	12
Journal	American Journal of Gastroenterology
Volume	118
Issue number	9
DOIs	https://doi.org/10.14309/ajg.0000000000002269
Publication status	Published - 01-09-2023

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Hepatology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.14309/ajg.0000000000002269

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Ogino, T., Mizushima, T., Fujii, M., Sekido, Y., Eguchi, H., Nezu, R., Ikeuchi, H., Motoi, U., Futami, K., Okamoto, K., Nagahara, H., Watanabe, K., Okabayashi, K., Yamada, K., Ohge, H., Tanaka, S., Mizuuchi, Y., Ohkita, Y., Sato, Y., ... Sugihara, K. (2023). Crohn's Disease-Associated Anorectal Cancer Has a Poor Prognosis with High Local Recurrence: A Subanalysis of the Nationwide Japanese Study. American Journal of Gastroenterology, 118(9), 1626-1637. https://doi.org/10.14309/ajg.0000000000002269

@article{aef27bf9e674472d8d4c0a6819e08796,

title = "Crohn's Disease-Associated Anorectal Cancer Has a Poor Prognosis with High Local Recurrence: A Subanalysis of the Nationwide Japanese Study",

abstract = "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 = 233) and sporadic CRC (n = 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.RESULTS:Compared with sporadic cases, patients with CD-CRC were younger; more often had RC, multiple lesions, and mucinous adenocarcinoma; and had lower R0 resection rates. Five-year OS was worse for CD-CRC than for sporadic CRC (53.99% vs 71.17%, P < 0.001). Multivariable Cox regression analysis revealed that CD was associated with significantly poorer survival (hazard ratio 2.36, 95% confidence interval: 1.54-3.62, P < 0.0001). Evaluation by tumor location showed significantly worse 5-year OS and RFS of CD-RC compared with sporadic RC. Recurrence was identified in 39.57% of CD-RC cases and was mostly local.DISCUSSION:Poor prognosis of CD-CRC is attributable primarily to RC and high local recurrence. Local control is indispensable to improving prognosis.",

keywords = "Crohn's disease, colorectal cancer, recurrence",

author = "Takayuki Ogino and Tsunekazu Mizushima and Makoto Fujii and Yuki Sekido and Hidetoshi Eguchi and Riichiro Nezu and Hiroki Ikeuchi and Uchino Motoi and Kitaro Futami and Kinya Okamoto and Hisashi Nagahara and Kazuhiro Watanabe and Koji Okabayashi and Kazutaka Yamada and Hiroki Ohge and Shinji Tanaka and Yusuke Mizuuchi and Yoshiki Ohkita and Yu Sato and Hideki Ueno and Toru Kono and Michio Itabashi and Hideaki Kimura and Koya Hida and Yusuke Kinugasa and Kenichi Takahashi and Fumikazu Koyama and Tsunekazu Hanai and Kiyoshi Maeda and Toshihiro Noake and Yoshifumi Shimada and Takayuki Yamamoto and Junya Arakaki and Keiji Mastuda and Junji Okuda and Eiji Sunami and Yoshito Akagi and Kenji Kastumata and Kay Uehara and Takeshi Yamada and Shin Sasaki and Soichiro Ishihara and Yoichi Ajioka and Kenichi Sugihara",

year = "2023",

month = sep,

day = "1",

doi = "10.14309/ajg.0000000000002269",

language = "English",

volume = "118",

pages = "1626--1637",

journal = "American Journal of Gastroenterology",

issn = "0002-9270",

publisher = "Wolters Kluwer Health",

number = "9",

}

Ogino, T, Mizushima, T, Fujii, M, Sekido, Y, Eguchi, H, Nezu, R, Ikeuchi, H, Motoi, U, Futami, K, Okamoto, K, Nagahara, H, Watanabe, K, Okabayashi, K, Yamada, K, Ohge, H, Tanaka, S, Mizuuchi, Y, Ohkita, Y, Sato, Y, Ueno, H, Kono, T, Itabashi, M, Kimura, H, Hida, K, Kinugasa, Y, Takahashi, K, Koyama, F, Hanai, T, Maeda, K, Noake, T, Shimada, Y, Yamamoto, T, Arakaki, J, Mastuda, K, Okuda, J, Sunami, E, Akagi, Y, Kastumata, K, Uehara, K, Yamada, T, Sasaki, S, Ishihara, S, Ajioka, Y & Sugihara, K 2023, 'Crohn's Disease-Associated Anorectal Cancer Has a Poor Prognosis with High Local Recurrence: A Subanalysis of the Nationwide Japanese Study', American Journal of Gastroenterology, vol. 118, no. 9, pp. 1626-1637. https://doi.org/10.14309/ajg.0000000000002269

TY - JOUR

T1 - Crohn's Disease-Associated Anorectal Cancer Has a Poor Prognosis with High Local Recurrence

T2 - A Subanalysis of the Nationwide Japanese Study

AU - Ogino, Takayuki

AU - Mizushima, Tsunekazu

AU - Fujii, Makoto

AU - Sekido, Yuki

AU - Eguchi, Hidetoshi

AU - Nezu, Riichiro

AU - Ikeuchi, Hiroki

AU - Motoi, Uchino

AU - Futami, Kitaro

AU - Okamoto, Kinya

AU - Nagahara, Hisashi

AU - Watanabe, Kazuhiro

AU - Okabayashi, Koji

AU - Yamada, Kazutaka

AU - Ohge, Hiroki

AU - Tanaka, Shinji

AU - Mizuuchi, Yusuke

AU - Ohkita, Yoshiki

AU - Sato, Yu

AU - Ueno, Hideki

AU - Kono, Toru

AU - Itabashi, Michio

AU - Kimura, Hideaki

AU - Hida, Koya

AU - Kinugasa, Yusuke

AU - Takahashi, Kenichi

AU - Koyama, Fumikazu

AU - Hanai, Tsunekazu

AU - Maeda, Kiyoshi

AU - Noake, Toshihiro

AU - Shimada, Yoshifumi

AU - Yamamoto, Takayuki

AU - Arakaki, Junya

AU - Mastuda, Keiji

AU - Okuda, Junji

AU - Sunami, Eiji

AU - Akagi, Yoshito

AU - Kastumata, Kenji

AU - Uehara, Kay

AU - Yamada, Takeshi

AU - Sasaki, Shin

AU - Ishihara, Soichiro

AU - Ajioka, Yoichi

AU - Sugihara, Kenichi

PY - 2023/9/1

Y1 - 2023/9/1

N2 - 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 = 233) and sporadic CRC (n = 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.RESULTS:Compared with sporadic cases, patients with CD-CRC were younger; more often had RC, multiple lesions, and mucinous adenocarcinoma; and had lower R0 resection rates. Five-year OS was worse for CD-CRC than for sporadic CRC (53.99% vs 71.17%, P < 0.001). Multivariable Cox regression analysis revealed that CD was associated with significantly poorer survival (hazard ratio 2.36, 95% confidence interval: 1.54-3.62, P < 0.0001). Evaluation by tumor location showed significantly worse 5-year OS and RFS of CD-RC compared with sporadic RC. Recurrence was identified in 39.57% of CD-RC cases and was mostly local.DISCUSSION:Poor prognosis of CD-CRC is attributable primarily to RC and high local recurrence. Local control is indispensable to improving prognosis.

AB - 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 = 233) and sporadic CRC (n = 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.RESULTS:Compared with sporadic cases, patients with CD-CRC were younger; more often had RC, multiple lesions, and mucinous adenocarcinoma; and had lower R0 resection rates. Five-year OS was worse for CD-CRC than for sporadic CRC (53.99% vs 71.17%, P < 0.001). Multivariable Cox regression analysis revealed that CD was associated with significantly poorer survival (hazard ratio 2.36, 95% confidence interval: 1.54-3.62, P < 0.0001). Evaluation by tumor location showed significantly worse 5-year OS and RFS of CD-RC compared with sporadic RC. Recurrence was identified in 39.57% of CD-RC cases and was mostly local.DISCUSSION:Poor prognosis of CD-CRC is attributable primarily to RC and high local recurrence. Local control is indispensable to improving prognosis.

KW - Crohn's disease

KW - colorectal cancer

KW - recurrence

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U2 - 10.14309/ajg.0000000000002269

DO - 10.14309/ajg.0000000000002269

M3 - Article

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AN - SCOPUS:85169186602

SN - 0002-9270

VL - 118

SP - 1626

EP - 1637

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

IS - 9

ER -

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

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