Difference in the clinical characteristic and prognosis of colitis-associated cancer and sporadic neoplasia in ulcerative colitis patients

Research output: Contribution to journalArticle

Abstract

Background: Although various studies have been conducted on colitis-associated cancer (CAC), few have assessed the differences in the clinical and endoscopic features, treatment, and prognosis of CAC and sporadic neoplasia (SN)in the inflamed mucosa of ulcerative colitis (UC)patients. Aims: To compare the characteristics of CAC and SN within the previously or currently inflamed mucosa. Methods: Between 1997 and 2017, we retrospectively analyzed the endoscopic chart data of 348 colonic lesions from 266 UC patients. Non-dysplastic lesions and lesions located outside the inflamed mucosa were excluded. The diagnosis of CAC or SN was confirmed by conventional histopathological and immunohistochemical evaluation of p53 and Ki67. Results: In total, 74 patients with CAC (97 lesions)and 46 with SN (58)were enrolled. The proportions of patients with a younger age of onset of UC, with chronic persistent UC, and with severe inflamed mucosa were significantly higher in the CAC group. In the SN group, no flat lesions were found, whereas 26% of the lesions in the CAC group were flat. Sixteen patients died during a median follow-up of 6.1 years (interquartile range (IQR)1.8–11.1)in the CAC group, whereas 1 patient died during a median follow-up 3.2 years(IQR 1.4–4.6)in the SN group. Mortality from colorectal cancer was significantly higher (P = 0.015)in the CAC group (12/68; 17.6%)than in the SN group (1/44; 2.3%). The 5-year survival rate was 100% in the SN group and 97% in the CAC group for lesions located in the mucosa or submucosa. Conclusion: Recognizing differences in the characteristics of CAC and SN within the inflamed mucosa is critical to avoid unnecessary total colectomy in patients with SN.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Colitis
Ulcerative Colitis
Neoplasms
Mucous Membrane
Colectomy

Keywords

  • Adenoma-Like dysplasia
  • Colitis-Associated dysplasia
  • Colorectal cancer
  • Ulcerative colitis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{f8945516469d456897756de7985abe0d,
title = "Difference in the clinical characteristic and prognosis of colitis-associated cancer and sporadic neoplasia in ulcerative colitis patients",
abstract = "Background: Although various studies have been conducted on colitis-associated cancer (CAC), few have assessed the differences in the clinical and endoscopic features, treatment, and prognosis of CAC and sporadic neoplasia (SN)in the inflamed mucosa of ulcerative colitis (UC)patients. Aims: To compare the characteristics of CAC and SN within the previously or currently inflamed mucosa. Methods: Between 1997 and 2017, we retrospectively analyzed the endoscopic chart data of 348 colonic lesions from 266 UC patients. Non-dysplastic lesions and lesions located outside the inflamed mucosa were excluded. The diagnosis of CAC or SN was confirmed by conventional histopathological and immunohistochemical evaluation of p53 and Ki67. Results: In total, 74 patients with CAC (97 lesions)and 46 with SN (58)were enrolled. The proportions of patients with a younger age of onset of UC, with chronic persistent UC, and with severe inflamed mucosa were significantly higher in the CAC group. In the SN group, no flat lesions were found, whereas 26{\%} of the lesions in the CAC group were flat. Sixteen patients died during a median follow-up of 6.1 years (interquartile range (IQR)1.8–11.1)in the CAC group, whereas 1 patient died during a median follow-up 3.2 years(IQR 1.4–4.6)in the SN group. Mortality from colorectal cancer was significantly higher (P = 0.015)in the CAC group (12/68; 17.6{\%})than in the SN group (1/44; 2.3{\%}). The 5-year survival rate was 100{\%} in the SN group and 97{\%} in the CAC group for lesions located in the mucosa or submucosa. Conclusion: Recognizing differences in the characteristics of CAC and SN within the inflamed mucosa is critical to avoid unnecessary total colectomy in patients with SN.",
keywords = "Adenoma-Like dysplasia, Colitis-Associated dysplasia, Colorectal cancer, Ulcerative colitis",
author = "Makoto Mutaguchi and Makoto Naganuma and Shinya Sugimoto and Tomohiro Fukuda and Kosaku Nanki and Shinta Mizuno and Naoki Hosoe and Masayuki Shimoda and Haruhiko Ogata and Yasushi Iwao and Takanori Kanai",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.dld.2019.05.003",
language = "English",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",

}

TY - JOUR

T1 - Difference in the clinical characteristic and prognosis of colitis-associated cancer and sporadic neoplasia in ulcerative colitis patients

AU - Mutaguchi, Makoto

AU - Naganuma, Makoto

AU - Sugimoto, Shinya

AU - Fukuda, Tomohiro

AU - Nanki, Kosaku

AU - Mizuno, Shinta

AU - Hosoe, Naoki

AU - Shimoda, Masayuki

AU - Ogata, Haruhiko

AU - Iwao, Yasushi

AU - Kanai, Takanori

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Although various studies have been conducted on colitis-associated cancer (CAC), few have assessed the differences in the clinical and endoscopic features, treatment, and prognosis of CAC and sporadic neoplasia (SN)in the inflamed mucosa of ulcerative colitis (UC)patients. Aims: To compare the characteristics of CAC and SN within the previously or currently inflamed mucosa. Methods: Between 1997 and 2017, we retrospectively analyzed the endoscopic chart data of 348 colonic lesions from 266 UC patients. Non-dysplastic lesions and lesions located outside the inflamed mucosa were excluded. The diagnosis of CAC or SN was confirmed by conventional histopathological and immunohistochemical evaluation of p53 and Ki67. Results: In total, 74 patients with CAC (97 lesions)and 46 with SN (58)were enrolled. The proportions of patients with a younger age of onset of UC, with chronic persistent UC, and with severe inflamed mucosa were significantly higher in the CAC group. In the SN group, no flat lesions were found, whereas 26% of the lesions in the CAC group were flat. Sixteen patients died during a median follow-up of 6.1 years (interquartile range (IQR)1.8–11.1)in the CAC group, whereas 1 patient died during a median follow-up 3.2 years(IQR 1.4–4.6)in the SN group. Mortality from colorectal cancer was significantly higher (P = 0.015)in the CAC group (12/68; 17.6%)than in the SN group (1/44; 2.3%). The 5-year survival rate was 100% in the SN group and 97% in the CAC group for lesions located in the mucosa or submucosa. Conclusion: Recognizing differences in the characteristics of CAC and SN within the inflamed mucosa is critical to avoid unnecessary total colectomy in patients with SN.

AB - Background: Although various studies have been conducted on colitis-associated cancer (CAC), few have assessed the differences in the clinical and endoscopic features, treatment, and prognosis of CAC and sporadic neoplasia (SN)in the inflamed mucosa of ulcerative colitis (UC)patients. Aims: To compare the characteristics of CAC and SN within the previously or currently inflamed mucosa. Methods: Between 1997 and 2017, we retrospectively analyzed the endoscopic chart data of 348 colonic lesions from 266 UC patients. Non-dysplastic lesions and lesions located outside the inflamed mucosa were excluded. The diagnosis of CAC or SN was confirmed by conventional histopathological and immunohistochemical evaluation of p53 and Ki67. Results: In total, 74 patients with CAC (97 lesions)and 46 with SN (58)were enrolled. The proportions of patients with a younger age of onset of UC, with chronic persistent UC, and with severe inflamed mucosa were significantly higher in the CAC group. In the SN group, no flat lesions were found, whereas 26% of the lesions in the CAC group were flat. Sixteen patients died during a median follow-up of 6.1 years (interquartile range (IQR)1.8–11.1)in the CAC group, whereas 1 patient died during a median follow-up 3.2 years(IQR 1.4–4.6)in the SN group. Mortality from colorectal cancer was significantly higher (P = 0.015)in the CAC group (12/68; 17.6%)than in the SN group (1/44; 2.3%). The 5-year survival rate was 100% in the SN group and 97% in the CAC group for lesions located in the mucosa or submucosa. Conclusion: Recognizing differences in the characteristics of CAC and SN within the inflamed mucosa is critical to avoid unnecessary total colectomy in patients with SN.

KW - Adenoma-Like dysplasia

KW - Colitis-Associated dysplasia

KW - Colorectal cancer

KW - Ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=85066091212&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066091212&partnerID=8YFLogxK

U2 - 10.1016/j.dld.2019.05.003

DO - 10.1016/j.dld.2019.05.003

M3 - Article

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

ER -