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

研究成果: ジャーナルへの寄稿学術論文査読

3 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)1626-1637
ページ数12
ジャーナルAmerican Journal of Gastroenterology
118
9
DOI
出版ステータス出版済み - 01-09-2023

All Science Journal Classification (ASJC) codes

  • 肝臓学
  • 消化器病学

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