Han Yoon Dae, Al Bandar Mahdi Hussain, Dulskas Audrius, Cho Min Soo, Hur Hyuk, Min Byung Soh, Lee Kang Young, Kim Nam Kyu
Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752, Korea.
Department of Oncosurgery, National Cancer Institute, Vilnius, Lithuania.
BMC Surg. 2017 Mar 21;17(1):28. doi: 10.1186/s12893-017-0224-z.
Ulcerative colitis (UC) harbours a high risk of UC-associated colorectal cancer (UCCC), which is important cause of morbidity and mortality in patients with inflammatory bowel disease. Overall Survival (OS) of patients with UCCC has not been addressed well in the literature. Thus, we compared oncologic outcome of UCCC and sporadic colorectal cancer (SCC) using propensity score matching analysis.
Propensity score matching was performed for 36 patients, a 1:1 matching method stratified into 18 in UCCC and 18 patients in SCC. Matched variables were sex, age, body mass index, tumour stage, histology, preoperative carcinoembryonic antigen (CEA) level, and adjuvant treatment status. Patients with SCC or UCCC were retrospectively retrieved from our database from March 2000 to December 2015. All patients had undergone either oncological segmental resection or total proctocolectomy.
The majority of cancers were found in the sigmoid colon. Total proctocolectomy was performed only in the UCCC group; however, half of the UCCC group underwent a standard operation. Five cases of postoperative complication occurred within six months in the UCCC group compared to one case in the SCC group. There was no significant difference in recurrence rate (p = 0.361) or OS (p = 0.896) between the arms.
UCCC showed more postoperative complications than SCC, and equivalent oncology outcome, however the difference was not statistically significant. This study represents an experience of a single institution, thus further randomized studies are required to confirm our.
溃疡性结肠炎（UC）伴有较高的UC相关结直肠癌（UCCC）风险，这是炎症性肠病患者发病和死亡的重要原因。UCCC患者的总生存期（OS）在文献中尚未得到充分探讨。因此，我们使用倾向评分匹配分析比较了UCCC和散发性结直肠癌（SCC）的肿瘤学结局。
对36例患者进行倾向评分匹配，采用1:1匹配方法，将18例患者分为UCCC组，18例患者分为SCC组。匹配变量包括性别、年龄、体重指数、肿瘤分期、组织学、术前癌胚抗原（CEA）水平和辅助治疗状态。2000年3月至2015年12月从我们的数据库中回顾性检索SCC或UCCC患者。所有患者均接受了肿瘤节段性切除或全直肠结肠切除术。
大多数癌症发生在乙状结肠。仅在UCCC组进行了全直肠结肠切除术；然而，UCCC组中有一半患者接受了标准手术。UCCC组在术后6个月内发生了5例术后并发症，而SCC组为1例。两组之间的复发率（p = 0.361）或OS（p = 0.896）无显著差异。
UCCC术后并发症比SCC更多，肿瘤学结局相当，但差异无统计学意义。本研究代表了单一机构的经验，因此需要进一步的随机研究来证实我们的结论。
