Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark.
Department of Surgery, Nordsjællands Hospital Hillerød, Hillerød, Denmark.
Ann Surg Oncol. 2022 Apr;29(4):2505-2512. doi: 10.1245/s10434-021-10759-8. Epub 2021 Sep 5.
Ulcerative colitis is associated with a higher risk for developing colorectal cancer. It is unknown whether this translates into a worse prognosis when malignancy occurs. The goal of this study was to compare long-term outcomes between patients with ulcerative colitis-associated colorectal cancer and sporadic colorectal cancer.
All patients who underwent surgery with curative intent for colorectal cancer in Denmark between January 2004 and June 2016 were included in the study. Patients diagnosed with ulcerative colitis were identified and matched 1:5 with patients with sporadic colorectal cancer using propensity score matching. The primary outcome was disease-free survival, with recurrence-free survival and all-cause mortality as secondary outcomes. In order to relate the results of the study to the existing literature, a systematic review with meta-analysis was conducted.
A total of 1332 patients, 222 with ulcerative colitis and 1110 with sporadic colorectal cancer were included in the study. Disease-free survival was similar between the two groups with a hazards ratio (HR) 1.06 [95% confidence interval (CI) 0.85-1.32], as was recurrence-free survival HR 1.14 (95% CI 0.86-1.53) and all-cause mortality HR 1.15 (95% CI 0.89-1.48). The results of the systematic review identified seven other relevant studies. Meta-analysis showed a HR 1.67 (95% CI 0.61-4.56) for recurrence-free survival and HR 1.21 (95% CI 0.93-1.56) for all-cause mortality.
There were no significant differences in long-term outcomes between ulcerative colitis-associated and sporadic colorectal cancer. However, the current results are limited by possible residual confounding and the meta-analysis by heterogeneity in confounding adjustment.
溃疡性结肠炎与结直肠癌的发生风险较高相关。当恶性肿瘤发生时，其是否会导致更差的预后尚不清楚。本研究的目的是比较溃疡性结肠炎相关结直肠癌与散发性结直肠癌患者的长期结局。
本研究纳入了 2004 年 1 月至 2016 年 6 月期间在丹麦接受结直肠癌根治性手术的所有患者。通过识别诊断为溃疡性结肠炎的患者，并使用倾向评分匹配，以 1:5 的比例与散发性结直肠癌患者进行匹配。主要结局是无病生存，次要结局是无复发生存和全因死亡率。为了使研究结果与现有文献相关，进行了系统评价和荟萃分析。
本研究共纳入了 1332 名患者，其中 222 名患有溃疡性结肠炎，1110 名患有散发性结直肠癌。两组之间的无病生存率相似，风险比（HR）为 1.06（95%置信区间（CI）为 0.85-1.32），无复发生存率的 HR 为 1.14（95%CI 为 0.86-1.53），全因死亡率的 HR 为 1.15（95%CI 为 0.89-1.48）。系统评价确定了另外 7 项相关研究。荟萃分析显示，无复发生存率的 HR 为 1.67（95%CI 为 0.61-4.56），全因死亡率的 HR 为 1.21（95%CI 为 0.93-1.56）。
溃疡性结肠炎相关结直肠癌与散发性结直肠癌的长期结局无显著差异。然而，目前的结果受到可能存在的残余混杂因素的限制，荟萃分析受到混杂因素调整方面异质性的限制。
