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

Humans Colitis, Ulcerative / complications Crohn Disease / complications Colitis-Associated Neoplasms / complications Retrospective Studies Intestinal Neoplasms Ulcer / complications
Crohn’s disease Intestinal cancers Ulcerative colitis

Journal

Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794

Informations de publication

Date de publication:
01 2023
Historique:
received: 22 02 2022
accepted: 21 09 2022
pubmed: 2 10 2022
medline: 11 1 2023
entrez: 1 10 2022
Statut: ppublish

Résumé

Patients with longstanding inflammatory bowel disease are at high risk of developing intestinal cancers. In this study, we aimed to elucidate the differences between intestinal cancers associated with ulcerative colitis and Crohn's disease. Intestinal cancers in ulcerative colitis and Crohn's disease patients treated between 1983 and 2020 at 43 Japanese institutions were retrospectively analyzed.. A total of 1505 intestinal cancers in 1189 ulcerative colitis and 316 Crohn's disease patients were studied. Almost all of ulcerative colitis-associated cancers (99%) were in the colon and rectum, whereas half of Crohn's disease-associated cancers (44%) were in the anus, with 11% in the small intestine. Ulcerative colitis-associated cancers were diagnosed more frequently by surveillance (67% vs. 25%, P < 0.0001) and at earlier stages (stages 0-1, 71% vs. 27%, P < 0.0001) compared with Crohn's disease-associated cancers. Colorectal cancers associated with Crohn's disease showed a significantly worse 5-year overall survival rate than those associated with ulcerative colitis (stage 2, 76% vs. 89%, P = 0.01, stage 3, 18% vs. 68%, P = 0.0009, and stage 4, 0% vs. 13%, P = 0.04). Surveillance correlated with earlier diagnoses for ulcerative colitis- and Crohn's disease-associated intestinal cancers, whereas shorter intervals between endoscopic examinations correlated with an earlier cancer diagnosis in ulcerative colitis patients but not in Crohn's disease patients. The clinical and oncological features of ulcerative colitis- and Crohn's disease-associated cancers were very different. Crohn's disease-associated cancers were diagnosed at more advanced stages and were detected less frequently by surveillance. Additionally, they showed a significantly poorer prognosis.

Sections du résumé

BACKGROUND
Patients with longstanding inflammatory bowel disease are at high risk of developing intestinal cancers. In this study, we aimed to elucidate the differences between intestinal cancers associated with ulcerative colitis and Crohn's disease.
METHODS
Intestinal cancers in ulcerative colitis and Crohn's disease patients treated between 1983 and 2020 at 43 Japanese institutions were retrospectively analyzed..
RESULTS
A total of 1505 intestinal cancers in 1189 ulcerative colitis and 316 Crohn's disease patients were studied. Almost all of ulcerative colitis-associated cancers (99%) were in the colon and rectum, whereas half of Crohn's disease-associated cancers (44%) were in the anus, with 11% in the small intestine. Ulcerative colitis-associated cancers were diagnosed more frequently by surveillance (67% vs. 25%, P < 0.0001) and at earlier stages (stages 0-1, 71% vs. 27%, P < 0.0001) compared with Crohn's disease-associated cancers. Colorectal cancers associated with Crohn's disease showed a significantly worse 5-year overall survival rate than those associated with ulcerative colitis (stage 2, 76% vs. 89%, P = 0.01, stage 3, 18% vs. 68%, P = 0.0009, and stage 4, 0% vs. 13%, P = 0.04). Surveillance correlated with earlier diagnoses for ulcerative colitis- and Crohn's disease-associated intestinal cancers, whereas shorter intervals between endoscopic examinations correlated with an earlier cancer diagnosis in ulcerative colitis patients but not in Crohn's disease patients.
CONCLUSIONS
The clinical and oncological features of ulcerative colitis- and Crohn's disease-associated cancers were very different. Crohn's disease-associated cancers were diagnosed at more advanced stages and were detected less frequently by surveillance. Additionally, they showed a significantly poorer prognosis.

Identifiants

DOI: 10.1007/s00535-022-01927-y PMID: 36182971
pubmed: 36182971
doi: 10.1007/s00535-022-01927-y
pii: 10.1007/s00535-022-01927-y
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

14-24

Informations de copyright

© 2022. Japanese Society of Gastroenterology.

Références

Kaplan GG, Ng SC. Understanding and preventing the global increase of inflammatory bowel disease. Gastroenterology. 2017;152:313-21.e2.
doi: 10.1053/j.gastro.2016.10.020
Ekbom A, Helmick C, Zack M, et al. Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med. 1990;323:1228–33.
doi: 10.1056/NEJM199011013231802
Ekbom A, Helmick C, Zack M, et al. Increased risk of large-bowel cancer in Crohn’s disease with colonic involvement. Lancet (London, England). 1990;336:357–9.
doi: 10.1016/0140-6736(90)91889-I
Uchino M, Ikeuchi H, Hata K, et al. Changes in the rate of and trends in colectomy for ulcerative colitis during the era of biologics and calcineurin inhibitors based on a Japanese nationwide cohort study. Surg Today. 2019;49:1066–73.
doi: 10.1007/s00595-019-01845-2
Watanabe T, Ajioka Y, Mitsuyama K, et al. Comparison of targeted vs random biopsies for surveillance of ulcerative colitis-associated colorectal cancer. Gastroenterology. 2016;151:1122–30.
doi: 10.1053/j.gastro.2016.08.002
Bye WA, Ma C, Nguyen TM, et al. Strategies for detecting colorectal cancer in patients with inflammatory bowel disease: a cochrane systematic review and meta-analysis. Am J Gastroenterol. 2018;113:1801–9.
doi: 10.1038/s41395-018-0354-7
Magro F, Gionchetti P, Eliakim R, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J Crohn's Colitis. 2017;11:649–670.
Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019;114:384–413.
doi: 10.14309/ajg.0000000000000152
Farraye FA, Odze RD, Eaden J, et al. AGA technical review on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010;138:746–74, 774 e1–4; quiz e12–3.
Cairns SR, Scholefield JH, Steele RJ, et al. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut. 2010;59:666–89.
doi: 10.1136/gut.2009.179804
Cole EB, Shah Y, McLean LP, et al. Frequency of surveillance and impact of surveillance colonoscopies in patients with ulcerative colitis who developed colorectal cancer. Clin Colorectal Cancer. 2018;17:e289–92.
doi: 10.1016/j.clcc.2018.01.002
Ananthakrishnan AN, Cagan A, Cai T, et al. Colonoscopy is associated with a reduced risk for colon cancer and mortality in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2015;13:322-329.e1.
doi: 10.1016/j.cgh.2014.07.018
Jess T, Loftus EV Jr, Velayos FS, et al. Risk of intestinal cancer in inflammatory bowel disease: a population-based study from olmsted county. Minnesota Gastroenterol. 2006;130:1039–46.
doi: 10.1053/j.gastro.2005.12.037
Gillen CD, Andrews HA, Prior P, et al. Crohn’s disease and colorectal cancer. Gut. 1994;35:651–5.
doi: 10.1136/gut.35.5.651
Dossett LA, White LM, Welch DC, et al. Small bowel adenocarcinoma complicating Crohn’s disease: case series and review of the literature. Am Surg. 2007;73:1181–7.
doi: 10.1177/000313480707301122
Watanabe T, Konishi T, Kishimoto J, et al. Ulcerative colitis-associated colorectal cancer shows a poorer survival than sporadic colorectal cancer: a nationwide Japanese study. Inflamm Bowel Dis. 2011;17:802–8.
doi: 10.1002/ibd.21365
Olén O, Erichsen R, Sachs MC, et al. Colorectal cancer in ulcerative colitis: a Scandinavian population-based cohort study. The Lancet. 2020;395:123–31.
doi: 10.1016/S0140-6736(19)32545-0
Sasaki H, Ikeuchi H, Bando T, et al. Clinicopathological characteristics of cancer associated with Crohn’s disease. Surg Today. 2017;47:35–41.
doi: 10.1007/s00595-016-1336-2
Olén O, Erichsen R, Sachs MC, et al. Colorectal cancer in Crohn’s disease: a Scandinavian population-based cohort study. Lancet Gastroenterol Hepatol. 2020;5:475–84.
doi: 10.1016/S2468-1253(20)30005-4
Choi PM, Zelig MP. Similarity of colorectal cancer in Crohn’s disease and ulcerative colitis: implications for carcinogenesis and prevention. Gut. 1994;35:950–4.
doi: 10.1136/gut.35.7.950
Arhi C, Askari A, Nachiappan S, et al. Stage at diagnosis and survival of colorectal cancer with or without underlying inflammatory bowel disease: a population-based study. J Crohns Colitis. 2021;15:375–82.
doi: 10.1093/ecco-jcc/jjaa196
Japan Society for Cancer of the Colon and Rectum. Multi-institutional registry of large bowel cancer in Japan Vol. 33 Cases treated in 2007. 2018; Available from: http://www.jsccr.jp/registration/pdf/Vol_33.pdf .
Lutgens MW, Oldenburg B, Siersema PD, et al. Colonoscopic surveillance improves survival after colorectal cancer diagnosis in inflammatory bowel disease. Br J Cancer. 2009;101:1671–5.
doi: 10.1038/sj.bjc.6605359
Hata K, Anzai H, Ikeuchi H, et al. Surveillance colonoscopy for ulcerative colitis-associated colorectal cancer offers better overall survival in real-world surgically resected cases. Am J Gastroenterol. 2019;114:483–9.
doi: 10.14309/ajg.0000000000000117
Hata K, Ishihara S, Watanabe T. Successful surveillance colonoscopy for patients with ulcerative colitis after ileorectal anastomosis. J Crohns Colitis. 2015;9:937–8.
doi: 10.1093/ecco-jcc/jjv124
Higashi D, Katsuno H, Kimura H, et al. Current state of and problems related to cancer of the intestinal tract associated with Crohn’s disease in Japan. Anticancer Res. 2016;36:3761–6.
Lakatos PL, David G, Pandur T, et al. Risk of colorectal cancer and small bowel adenocarcinoma in Crohn’s disease: a population-based study from western Hungary 1977–2008. J Crohns Colitis. 2011;5:122–8.
doi: 10.1016/j.crohns.2010.11.005
Hata K, Ishihara S, Ajioka Y, et al. Long-term follow-up of targeted biopsy yield (LOFTY Study) in ulcerative colitis surveillance colonoscopy. J Clin Med. 2020;9:2286.
doi: 10.3390/jcm9072286

Auteurs

Tatsuki Noguchi (T)

Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Soichiro Ishihara (S)

Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. ishihara-1su@h.u-tokyo.ac.jp.
ORCID: 0000-0003-0543-0045

Motoi Uchino (M)

Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine, Nishinomiya, Japan.

Hiroki Ikeuchi (H)

Department of Inflammatory Bowel Disease Surgery, Hyogo College of Medicine, Nishinomiya, Japan.

Koji Okabayashi (K)

Department of Surgery, Keio University School of Medicine, Tokyo, Japan.

Kitaro Futami (K)

Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.

Shinji Tanaka (S)

Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.

Hiroki Ohge (H)

Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan.

Hisashi Nagahara (H)

Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Kazuhiro Watanabe (K)

Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

Michio Itabashi (M)

Department of Surgery, Division of Inflammatory Bowel Disease Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Kinya Okamoto (K)

Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan.

Yoshiki Okita (Y)

Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan.

Tsunekazu Mizushima (T)

Department of Gastroenterological Surgery, Graduate School of Medical, Osaka University, Osaka, Japan.

Yusuke Mizuuchi (Y)

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Kazutaka Yamada (K)

Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan.

Yoshifumi Shimada (Y)

Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Yu Sato (Y)

Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan.

Hideaki Kimura (H)

Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan.

Kenichi Takahashi (K)

Department of Colorectal Surgery, Tohoku Rosai Hospital, Sendai, Japan.

Koya Hida (K)

Department of Surgery, Kyoto University Hospital, Kyoto, Japan.

Yusuke Kinugasa (Y)

Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Junji Okuda (J)

Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.

Koji Daito (K)

Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan.

Fumikazu Koyama (F)

Department of Surgery, Nara Medical University, Kashihara, Japan.

Hideki Ueno (H)

Department of Surgery, National Defense Medical College, Tokorozawa, Japan.

Takayuki Yamamoto (T)

Inflammatory Bowel Disease Center, Yokkaichi Hazu Medical Center, Yokkaichi, Japan.

Tsunekazu Hanai (T)

Department of Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.

Atsuo Maemoto (A)

Inflammatory Bowel Disease Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan.

Koji Oba (K)

Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Interfaculty Initiative in Information Studies, Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan.

Yoichi Ajioka (Y)

Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Kenichi Sugihara (K)

Tokyo Medical and Dental University, Tokyo, Japan.

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