Crohn's disease-related versus sporadic colorectal cancer: A stage-matched case-control study based on four decades of experience

J Surg Oncol. 2024 Sep;130(3):644-652. doi: 10.1002/jso.27768. Epub 2024 Jul 14.

Abstract

Background and objectives: This study compares surgical and oncological outcomes in patients with Crohn's disease (CD)-related colorectal cancer (CRC) to those with sporadic CRC.

Methods: Patients treated between 1983 and 2013 were matched by stage, age, gender, American Society of Anesthesiologists (ASA), cancer site, and adjuvant chemotherapy.

Results: For stages I and II, 107 patients were matched (58.9% male, mean age 59 years, 59.8% with ASA score 3). Tumor sites included the right (17.7%), transverse (4.7%), left colon (15.9%), and rectum (61.7%). CD patients exhibited longer operative times, higher pT stages, and 2.60 times the odds of postoperative complications (p = 0.03). Overall and disease-free survival were similar. For stage III, 54 patients were matched (57.4% male, mean age 54 years, 46.3% with ASA score 3). The cancer site distribution was right (29.7%), transverse (3.7%), left colon (18.5%), and rectum (48.1%). CD patients had longer operative times, increased blood loss, more involved lymph nodes, higher pT- and pN-stages. The rates of postoperative complications were not different (p = 0.19). CD-related CRC patients had similar overall (p = 0.06), and local recurrence-free survival (p = 0.07).

Conclusions: Despite facing worse perioperative and pathological characteristics, survival differences in stages I-III CD-related CRC compared with sporadic CRC patients were not significantly different.

Keywords: Crohn's disease; colorectal cancer; inflammatory bowel disease.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Crohn Disease* / mortality
  • Crohn Disease* / pathology
  • Crohn Disease* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Operative Time
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies