Colon Cancer Patients with Inflammatory Bowel Disease Do Not Necessarily Have

Worse Outcomes

Ramzi Amri, MD1,2 Liliana G Bordeianou, MD, MPH1,2 Patricia Sylla, MD1,2 and David L Berger, MD 1,2

1 Massachusetts General Hospital, Division of General and Gastrointestinal Surgery.2 Harvard Medical School, Department of Surgery.

Disclosures: none

04/15/23 10th Annual Academic Surgical Congress, February 3-5 2015, Las Vegas, NV07 - QuickShot: Clinical Research - Oncology

Introduction

• Inflammatory bowel disease (IBD) carries a high risk of developing colon cancer.1

• Its relationship with the eventual outcomes is less evident.

• Recent report2 confirmed early suspicions that IBD may be associated with worse survival.3

• Other reports did not identify differences.4

• We therefore reviewed characteristics of IBD-associated colon cancer in our population.

1. Triantafillidis JK, et al. Anticancer Res. 2009;29(7):2727–27372. Adams SV, et al. World J Gastroenterol. 2013;19(21):3241–3248.3. Richards ME, et al. Ann Surg. 1989 Jun;209(6):764-73.4. Delaunoit T, et al. Clin Gastroenterol Hepatol. 2006 Mar;4(3):335-42.

Methods

• Included: • Surgical colon cancer patients at MGH 2004-2011

(n=1071)• Patients with IBD: 38 (3.5%)• Crohn’s: 21 (2.0%), UC: 16 (1.5%), 1 mixed form

• Comparison:• Baseline pathology• Outcomes: survival, disease-free survival

• Statistical analysis• Ordinal: χ2, continuous: Mann Whitney U• Multivariate: Cox regression

Results

Conclusions

• IBD patients who develop colon cancer appear to have relatively better staging and outcomes.

• These differences were present despite significantly higher-grade disease on presentation.

• More aggressive tumor characteristics in colon cancer patients with comorbid IBD fit findings in earlier literature.

• Slightly better outcomes in IBD patients are an uncommon finding.• This incongruence may be explained by surveillance in IBD patients. Protective effect through early detection of cancers? Findings suggest that under adequate and regular follow up, IBD

patients are not inherently worse off when diagnosed with colon cancer.

Questions?