Crohn's disease-like reaction predicts favorable prognosis in colitis-associated colorectal cancer

Brian Lewis, Jingmei Lin, Xianrui Wu, Hao Xie, Bo Shen, Keith Lai, Elena Manilich, Xiuli Liu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Idiopathic inflammatory bowel disease is associated with an increased risk of developing colorectal cancer. Colitis-associated colorectal cancer (CAC) has unique histomorphology features; however, whether histomorphology is predictive of survival in CAC, independent of overall clinical tumor stage, remains unknown. The aim of this study is to determine if clinicodemographics and tumor histomorphologic features are prognostic in patients with CAC. Methods: A cohort of CAC patients were identified from the Pathology Database at Cleveland Clinic; slides were reviewed and other relevant data were collected by retrospective review of medical records. Results: Univariate analysis demonstrated that poor differentiation, N stage (N1/N2 versus N0), M stage (M1 versus M0), Tumor, Node, Metastasis (TNM) stage (III/IV versus I/II), positive margin, and Crohn's-like reaction were significantly associated with both overall survival (OS) and progression-free survival (PFS) in CAC. Additionally, the presence of >2 tumor-infiltrating lymphocytes/high-power field was found to be significantly associated with longer PFS. Multivariate analysis confirmed that high TNM stage (III/IV versus I/II) was associated with shorter OS and PFS (hazard ratio 2.7, 95% confidence interval [CI]: 1.1-6.7, P = 0.04; 4.84 [95% CI: 2.0-11.5], P < 0.001, respectively), and positive margin status was associated with shorter OS (hazard ratio 4.0 [95% CI: 1.0-15.7], P = 0.05), whereas the presence of Crohn's-like reaction was associated with longer OS and PFS (hazard ratio 0.3 [95% CI: 0.12-0.79], P = 0.02; 0.25 [95% CI: 0.11-0.58], P = 0.001, respectively). Conclusions: In CAC, high tumor clinical stage and positive margin predict worse survival but Crohn's disease-like reaction is associated with longer OS and PFS.

Original languageEnglish
Pages (from-to)2190-2198
Number of pages9
JournalInflammatory Bowel Diseases
Volume19
Issue number10
DOIs
StatePublished - Sep 2013

Fingerprint

Colitis
Crohn Disease
Colorectal Neoplasms
Disease-Free Survival
Survival
Confidence Intervals
Neoplasms
Neoplasm Metastasis
Tumor-Infiltrating Lymphocytes
Inflammatory Bowel Diseases
Medical Records
Multivariate Analysis
Databases
Pathology

Keywords

  • Colorectal cancer
  • Crohn's disease-like reaction
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Crohn's disease-like reaction predicts favorable prognosis in colitis-associated colorectal cancer. / Lewis, Brian; Lin, Jingmei; Wu, Xianrui; Xie, Hao; Shen, Bo; Lai, Keith; Manilich, Elena; Liu, Xiuli.

In: Inflammatory Bowel Diseases, Vol. 19, No. 10, 09.2013, p. 2190-2198.

Research output: Contribution to journalArticle

Lewis, Brian ; Lin, Jingmei ; Wu, Xianrui ; Xie, Hao ; Shen, Bo ; Lai, Keith ; Manilich, Elena ; Liu, Xiuli. / Crohn's disease-like reaction predicts favorable prognosis in colitis-associated colorectal cancer. In: Inflammatory Bowel Diseases. 2013 ; Vol. 19, No. 10. pp. 2190-2198.
@article{5d73b377709b4ed6a1da42dcb1e3b6ca,
title = "Crohn's disease-like reaction predicts favorable prognosis in colitis-associated colorectal cancer",
abstract = "Background: Idiopathic inflammatory bowel disease is associated with an increased risk of developing colorectal cancer. Colitis-associated colorectal cancer (CAC) has unique histomorphology features; however, whether histomorphology is predictive of survival in CAC, independent of overall clinical tumor stage, remains unknown. The aim of this study is to determine if clinicodemographics and tumor histomorphologic features are prognostic in patients with CAC. Methods: A cohort of CAC patients were identified from the Pathology Database at Cleveland Clinic; slides were reviewed and other relevant data were collected by retrospective review of medical records. Results: Univariate analysis demonstrated that poor differentiation, N stage (N1/N2 versus N0), M stage (M1 versus M0), Tumor, Node, Metastasis (TNM) stage (III/IV versus I/II), positive margin, and Crohn's-like reaction were significantly associated with both overall survival (OS) and progression-free survival (PFS) in CAC. Additionally, the presence of >2 tumor-infiltrating lymphocytes/high-power field was found to be significantly associated with longer PFS. Multivariate analysis confirmed that high TNM stage (III/IV versus I/II) was associated with shorter OS and PFS (hazard ratio 2.7, 95{\%} confidence interval [CI]: 1.1-6.7, P = 0.04; 4.84 [95{\%} CI: 2.0-11.5], P < 0.001, respectively), and positive margin status was associated with shorter OS (hazard ratio 4.0 [95{\%} CI: 1.0-15.7], P = 0.05), whereas the presence of Crohn's-like reaction was associated with longer OS and PFS (hazard ratio 0.3 [95{\%} CI: 0.12-0.79], P = 0.02; 0.25 [95{\%} CI: 0.11-0.58], P = 0.001, respectively). Conclusions: In CAC, high tumor clinical stage and positive margin predict worse survival but Crohn's disease-like reaction is associated with longer OS and PFS.",
keywords = "Colorectal cancer, Crohn's disease-like reaction, Prognosis, Survival",
author = "Brian Lewis and Jingmei Lin and Xianrui Wu and Hao Xie and Bo Shen and Keith Lai and Elena Manilich and Xiuli Liu",
year = "2013",
month = "9",
doi = "10.1097/MIB.0b013e31829e13e1",
language = "English",
volume = "19",
pages = "2190--2198",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "10",

}

TY - JOUR

T1 - Crohn's disease-like reaction predicts favorable prognosis in colitis-associated colorectal cancer

AU - Lewis, Brian

AU - Lin, Jingmei

AU - Wu, Xianrui

AU - Xie, Hao

AU - Shen, Bo

AU - Lai, Keith

AU - Manilich, Elena

AU - Liu, Xiuli

PY - 2013/9

Y1 - 2013/9

N2 - Background: Idiopathic inflammatory bowel disease is associated with an increased risk of developing colorectal cancer. Colitis-associated colorectal cancer (CAC) has unique histomorphology features; however, whether histomorphology is predictive of survival in CAC, independent of overall clinical tumor stage, remains unknown. The aim of this study is to determine if clinicodemographics and tumor histomorphologic features are prognostic in patients with CAC. Methods: A cohort of CAC patients were identified from the Pathology Database at Cleveland Clinic; slides were reviewed and other relevant data were collected by retrospective review of medical records. Results: Univariate analysis demonstrated that poor differentiation, N stage (N1/N2 versus N0), M stage (M1 versus M0), Tumor, Node, Metastasis (TNM) stage (III/IV versus I/II), positive margin, and Crohn's-like reaction were significantly associated with both overall survival (OS) and progression-free survival (PFS) in CAC. Additionally, the presence of >2 tumor-infiltrating lymphocytes/high-power field was found to be significantly associated with longer PFS. Multivariate analysis confirmed that high TNM stage (III/IV versus I/II) was associated with shorter OS and PFS (hazard ratio 2.7, 95% confidence interval [CI]: 1.1-6.7, P = 0.04; 4.84 [95% CI: 2.0-11.5], P < 0.001, respectively), and positive margin status was associated with shorter OS (hazard ratio 4.0 [95% CI: 1.0-15.7], P = 0.05), whereas the presence of Crohn's-like reaction was associated with longer OS and PFS (hazard ratio 0.3 [95% CI: 0.12-0.79], P = 0.02; 0.25 [95% CI: 0.11-0.58], P = 0.001, respectively). Conclusions: In CAC, high tumor clinical stage and positive margin predict worse survival but Crohn's disease-like reaction is associated with longer OS and PFS.

AB - Background: Idiopathic inflammatory bowel disease is associated with an increased risk of developing colorectal cancer. Colitis-associated colorectal cancer (CAC) has unique histomorphology features; however, whether histomorphology is predictive of survival in CAC, independent of overall clinical tumor stage, remains unknown. The aim of this study is to determine if clinicodemographics and tumor histomorphologic features are prognostic in patients with CAC. Methods: A cohort of CAC patients were identified from the Pathology Database at Cleveland Clinic; slides were reviewed and other relevant data were collected by retrospective review of medical records. Results: Univariate analysis demonstrated that poor differentiation, N stage (N1/N2 versus N0), M stage (M1 versus M0), Tumor, Node, Metastasis (TNM) stage (III/IV versus I/II), positive margin, and Crohn's-like reaction were significantly associated with both overall survival (OS) and progression-free survival (PFS) in CAC. Additionally, the presence of >2 tumor-infiltrating lymphocytes/high-power field was found to be significantly associated with longer PFS. Multivariate analysis confirmed that high TNM stage (III/IV versus I/II) was associated with shorter OS and PFS (hazard ratio 2.7, 95% confidence interval [CI]: 1.1-6.7, P = 0.04; 4.84 [95% CI: 2.0-11.5], P < 0.001, respectively), and positive margin status was associated with shorter OS (hazard ratio 4.0 [95% CI: 1.0-15.7], P = 0.05), whereas the presence of Crohn's-like reaction was associated with longer OS and PFS (hazard ratio 0.3 [95% CI: 0.12-0.79], P = 0.02; 0.25 [95% CI: 0.11-0.58], P = 0.001, respectively). Conclusions: In CAC, high tumor clinical stage and positive margin predict worse survival but Crohn's disease-like reaction is associated with longer OS and PFS.

KW - Colorectal cancer

KW - Crohn's disease-like reaction

KW - Prognosis

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=84884547655&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884547655&partnerID=8YFLogxK

U2 - 10.1097/MIB.0b013e31829e13e1

DO - 10.1097/MIB.0b013e31829e13e1

M3 - Article

VL - 19

SP - 2190

EP - 2198

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 10

ER -