Clinical Characteristics, Management and Outcomes of Colitis-associated Colorectal Cancer and the Comparison to Sporadic Colorectal Cancer in Taiwan.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2024-12-05 DOI:10.14309/ctg.0000000000000798

Hsin-Yun Wu, Meng-Tzu Weng, Jen-Wei Chou, Hsu-Heng Yen, Chun-Chi Lin, Feng-Fan Chiang, Chen-Shuan Chung, Wei-Chen Lin, Chen-Wang Chang, Puo-Hsien Le, Chia-Jung Kuo, Ching-Pin Lin, Wen-Hung Hsu, Chiao-Hsiung Chuang, Tzung-Jiun Tsai, I-Che Feng, Shu-Chen Wei, Tien-Yu Huang

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引用次数: 0

Abstract

Background: We explored the clinical characteristics, treatment, and outcomes of colitis-associated colorectal cancer and compared with sporadic colorectal cancer in Taiwan.

Methods: In this retrospective study spanning 1987-2022, colitis-associated colorectal cancers diagnosed according to endoscopic and pathological reports from 14 tertiary centers were reported to our cohort. Clinical demographics, endoscopic findings, histological results, treatment modalities, and outcomes were analyzed. Sporadic colorectal cancer data were retrieved from the Cancer Registry Annual Report, Ministry of Health and Welfare, Taiwan.

Results: We enrolled 65 colitis-associated colorectal cancer patients (median age: 56 years; male: 66.2%). Distal colon was the most common tumor location (41.5%). Of ulcerative colitis patients, 77.2% had extensive colitis and 76.5% had Mayo endoscopic subscores of ≥2. Moreover, 50% of lesions were nonpolypoid with indistinct borders in 66.7%. Signet-ring cell subtype consisted 12.3%. Surveillance colonoscopy adherence was 78.4%, yet 51.3% interval cancers occurred. Disease stage 0-4 distribution was 15%, 20%, 13.3%, 20%, and 31.7%, respectively. Endoscopic resection was feasible for 14%, while 67.7% required surgery. During follow-up (median: 21.5 months), we recorded 23.2% recurrence and 34.5% mortality. Lesions with indistinct borders were associated with adverse outcomes (adjusted odds ratio = 11.5 [1.35-98.16]). Colitis-associated rectal cancers, diagnosed later (p < 0.001), had worse outcomes than sporadic rectal cancers.

Conclusions: This is the largest Asian colitis-associated colorectal cancer cohort study, emphasizing the need for stringent disease control, improving detection and reducing interval cancers. Signet-ring cell subtype was prevalent. Rectal colitis-associated cancers were diagnosed later with poorer outcomes then sporadic rectal cancers.

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.