Abstract
Background: Inflammatory bowel disease (IBD) is a risk factor in developing colitis-associated colorectal cancer (CA-CRC). CA-CRC causes the death of about 15% IBD patients and the risk is 1.5–2.4 fold higher among IBD sufferers than in the general population. The dysplasia CA-CRC develops in a different mechanism in comparison to sporadic colorectal cancer (CRC). This study aimed at evaluating the surgical treatment and its outcomes as well as 5-year survival rates in the CA-CRC and sporadic CRC patients. Materials and methods: This single-center, retrospective, propensity score-matched case-control study was conducted with 2204 patients operated on due to primary CRC, who were hospitalized from 2003 to 2019. The CA-CRC group consisted of 49 patients with CRC in the course of IBD. The sporadic CRC group was selected with the propensity score matching technique and comprised 98 patients with sporadic CRC who did not have clinical or histopathological features characteristic for IBD. Results: CA-CRC is characterized by a more aggressive clinical course. Surgical treatment of CA-CRC involves more palliative operations and is related with a higher risk of perioperative and postoperative complications. Further studies of CA-CRC risk factor stratification and the development of molecular markers hold promise in reducing CRC in IBD patients in the future were warranted.
Highlights
Many risk factors for the development of colorectal cancer (CRC) have been identified and well established
The genetic factors coupled with the chronic inflammatory process in the colonic mucosa of Inflammatory bowel diseases (IBD) patients are hypothesized to play a significant role in carcinogenesis, and influencing the inflammatory process could lower this continuous process of inflammation related carcinogenesis in colonic tissue [5,6,7]
This single-center, retrospective, propensity score-matched case-control study has been conducted on 49 consecutive IBD patients operated on due to CRC, who were hospitalized from 2003 to 2019
Summary
Many risk factors for the development of colorectal cancer (CRC) have been identified and well established. Inflammatory bowel diseases (IBD) are confirmed as significant factor in development of CRC, especially involving young onset with more aggressive or advanced disease. Only 1–2% CRCs are related with the course of IBD. The most important and well-recognized risk factors for Colitis-associated cancer colorectal cancer (CA-CRC) are duration and extent of intestinal inflammatory lesions [1,2,3,4]. The genetic factors coupled with the chronic inflammatory process in the colonic mucosa of IBD patients are hypothesized to play a significant role in carcinogenesis, and influencing the inflammatory process could lower this continuous process of inflammation related carcinogenesis in colonic tissue [5,6,7]. In contrast to occasional CRC, CA-CRC occurs at a younger age, it is more often located proximally, and synchronic lesions are more frequent [6]
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