P533 Colectomy rate and mortality in hospitalized severe ulcerative colitis patients over the past 40 years

Abstract

1 dose) and IMM ( 6mos) use was reported. Statistical analysis: data expressed as median (range); Student’s T test, Chi squared test. Results: During the study period, 2387 IBD patients were in follow up: 384 (16%) received anti-TNFs. From 2000 to 2013, 15 IBD patients (9 CD, 6 UC) developed cancer of the lower GI tract (0.62%), including 12 colon cancers (6 UC, 6 CD), 1 ileal adenocarcinoma (1 CD), 1 carcinoid of the appendix (1 CD), 1 anal canal squamous carcinoma (1 CD). Among the 15 IBD-K (7 M), median age at diagnosis of cancer was 51 (28 73) yrs, IBD duration 19 yrs (1 47). CD involved the ileum (I) in 4 patients, the colon (C) in 2 patients and the ileum colon (IC) in 3 patients; UC was distal in 3, left-sided in 1 and total in 2 patients. Among the 15 IBD-K patients, 3 (20%) received anti-TNFs and/or IMM (all 3 received both). These 3 patients developed cancer (2 colon, 1 carcinoid): 2 CD (2 F, age 40 and 54 yrs, CD duration 28 and 26 yrs; fistulizing IC) and 1 UC (1 F, age 30, duration 19 yrs; pancolitis). Among the 384/2387 (16%) IBD patients treated with anti-TNFs during the 13 years follow up, colon cancer developed in 3 (0.78%) (all 3 patients also treated with IMM). Among the 2003/2387 patients never treated with anti-TNFs during the follow up, 12 (0.6%) developed cancer of the lower GI tract, 10 (0.5%) colon cancer (p = ns vs patients treated with anti-TNFs). IBD-C included 30 patients (18 CD, 12 UC; 14 M/16 F, age 54 yrs, range 37 75; CD of the I (n = 13), C (n = 2), IC (n = 3); UC was distal (n = 11), left-sided (n = 1) or total (n = 0). Anti-TNFs were used by a comparable number of IBD patients developing or not cancer (IBD-C n = 6/30; 20% vs IBD-K n = 3/15; 20%). In IBD-C, IMM use was reported in 10 (33%) (combined with anti-TNFs in 2; 6.7%). Conclusions: In a retrospective matched-pair study, a comparable low frequency of colon cancer was observed in IBD patients treated or untreated with anti-TNFs.