Affiliation:
1. Department for Colorectal Surgery, Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA
2. Department of Quantitative Health Sciences Cleveland Clinic Cleveland Ohio USA
Abstract
AbstractBackground and ObjectivesThis study compares surgical and oncological outcomes in patients with Crohn's disease (CD)‐related colorectal cancer (CRC) to those with sporadic CRC.MethodsPatients treated between 1983 and 2013 were matched by stage, age, gender, American Society of Anesthesiologists (ASA), cancer site, and adjuvant chemotherapy.ResultsFor 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).ConclusionsDespite facing worse perioperative and pathological characteristics, survival differences in stages I–III CD‐related CRC compared with sporadic CRC patients were not significantly different.