Analysis of clinicopathological features and oncological outcomes of ulcerative colitis-associated colorectal cancer based on macroscopic classification.
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Saito Ayano, Yokoyama Yuichiro, Uchino Motoi, Ikeuchi Hiroki, Okabayashi Koji, Oka Shiro, Higashi Daijiro, Ogawa Shimpei, Watanabe Kazuhiro, Shibutani Masatsune, Okita Yoshiki, Wakai Toshifumi, Mizuuchi Yusuke, Okamoto Kinya, Yamada Kazutaka, Sato Yu, Ogino Takayuki, Kimura Hideaki, Takahashi Kenichi, Hida Koya, Kinugasa Yusuke, Ishida Fumio, Okuda Junji, Daito Koji, Yamamoto Takayuki, Yamamoto Seiichiro, Koyama Fumikazu, Hanai Tsunekazu, Komori Koji, Shida Dai, Arakaki Junya, Fujita Fumihiko, Yamaguchi Shigeki, Ueno Hideki, Matsuda Keiji, Maemoto Atsuo, Nezu Riichiro, Sasaki Shin, Sunami Eiji, Noguchi Tatsuki, Sugihara Kenichi, Ajioka Yoichi, Ishihara Soichiro, Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon, Rectum
Аннотация
METHODS: The cohort included 480 patients with UC-CRC with invasion beyond the muscularis propria treated at 43 Japanese institutions between 1983 and 2023. The patients were divided into six groups based on the macroscopic type (types 0-5), and clinicopathological features and prognoses were compared.
RESULTS: Among 480 patients, 66 (13.8%), 75 (15.6%), 116 (24.2%), 63 (13.1%), 68 (14.2%), and 92 (19.2%) had type 0-5 tumors, respectively. There were significant differences in the clinicopathological characteristics with a younger age in type 4 or 5 tumors than in type 2 tumors (p < 0.01) and a higher frequency of undifferentiated carcinomas (p < 0.01) and lymph node metastasis (p < 0.01) and more advanced depth of invasion (p < 0.01) in type 4 tumors than in type 1 or 2 tumors. Type 4 and 5 were independent risk factors for 5-year recurrence-free survival (p = 0.02; type 4 [HR: 6.35], type 5 [HR: 5.25]) and type 0, 4, and 5 for overall survival (p = 0.02; type 0 [HR: 4.51], type 4 [HR: 5.70], type 5 [HR: 4.02]).
CONCLUSIONS: Type 0, 4, and 5 tumors were characteristic macroscopic types of UC-CRC and correlated with worse prognosis. Therefore, endoscopic diagnosis of the macroscopic type of UC-CRC might be helpful in determining tumor aggressiveness.