Histomorphological features and prognosis of colitis-associated colorectal cancer in patients with primary sclerosing cholangitis. (November 2015)

• Record Type: Journal Article
• Authors: Liu, Ganglei; Lin, Jingmei; Xie, Hao; Shen, Bo; Stocchi, Luca; Liu, Xiuli
• Is Part Of: Scandinavian journal of gastroenterology. Volume 50:Number 11(2015)
• Page Start: 1389
• Page End: 1396
• Publication Date: 2015-11
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Background.</italic> </bold> Histomorphology of colitis-associated colorectal cancer (CAC) in patients with primary sclerosing cholangitis (PSC) remains to be systemically characterized and prognosis in these patient needs to be further defined. <bold><italic>Aim.</italic></bold> To examine the impact of PSC on histomorphology and to assess prognosis of CAC-PSC patients. <bold><italic>Methods.</italic></bold> A cohort of CAC patients were identified from the Pathology Database (1994–2010) at Cleveland Clinic; histomorphological features and other relevant data were collected by retrospective review of pathology slides and medical records. <bold><italic>Results.</italic></bold> A total of 87 CAC patients were included, with 11 patients having PSC (the study group) and 76 patients without PSC (the control group). The overall median follow up was 6 (range: 0–20) years. The patients in the study group had a longer median duration of inflammatory bowel disease prior to CAC diagnosis (<italic>p</italic> = 0.046). In study group, seven (63.6%) patients had right-sided CAC (vs. 36.8% in the control group, <italic>p</italic> = 0.11). Background high-grade dysplasia was noted less (9.1% vs. 44.7%), while low-grade dysplasia was detected more in the study group (72.7% vs. 28.9%) (<italic>p</italic> = 0.02). All histomorphological features were comparable between groups. The overall survival (OS) and progression-free survival (PFS) showed no statistical difference between CAC patients with or without PSC. After excluding TNM stage IV patients, patients with PSC showed a trend toward shorter OS and PFS (<italic>p</italic> = 0.07 and <italic>p</italic> = 0.1). <bold><italic>Conclusion.</italic></bold> In CAC, histomorphology appeared to be independent of PSC. PSC is associated with a trend toward shorter OS and PFS in CAC patients with stage I–III diseases.</p> </abstract>