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イタバシ ミチオ
Itabashi Michio
板橋 道朗 所属 医学部 医学科 職種 特任教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Crohn's Disease-Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study |
| 掲載誌名 | 正式名：The American journal of gastroenterology 略 称：Am J Gastroenterol ISSNコード：15720241/00029270 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 118(9),pp.1626-1637 |
| 著者・共著者 | OGINO Takayuki,MIZUSHIMA Tsunekazu,FUJII Makoto,SEKIDO Yuki,EGUCHI Hidetoshi,NEZU Riichiro,IKEUCHI Hiroki,MOTOI Uchino,FUTAMI Kitaro,OKAMOTO Kinya,NAGAHARA Hisashi,WATANABE Kazuhiro,OKABAYASHI Koji,YAMADA Kazutaka,OHGE Hiroki,TANAKA Shinji,MIZUUCHI Yusuke,OHKITA Yoshiki,SATO Yu,UENO Hideki,KONO Toru,ITABASHI Michio,KIMURA Hideaki,HIDA Koya,KINUGASA Yusuke,TAKANASHI Kenichi,KOYAMA Fumikazu,NHANAI Tsunekazu,MAEDA Kiyoshi,NOAKE Toshihiro,SHIMADA Yoshifumi,YAMAMOTO Takayuki,ARAKAKI Junya,MATSUDA Keiji,OKUDA Junji,SUNAMI Eiji,AKAGI Yoshito,KATSUMATA Kenji,UEHARA Kay,YAMADA Takeshi,SASAKI Shin,ISHIHARA Soichiro,AJIOKA Yoichi,SUGIHARA Kenichi |
| 発行年月 | 2023/09 |
| 概要 | INTRODUCTION:Colorectal cancer (CRC) is one of the major life-threatening complications in patients with Crohn's disease (CD). Previous studies of CD-associated CRC (CD-CRC) have involved only small numbers of patients, and no large series have been reported from Asia. The aim of this study was to clarify the prognosis and clinicopathological features of CD-CRC compared with sporadic CRC.METHODS:A large nationwide database was used to identify patients with CD-CRC (n = 233) and sporadic CRC (n = 129,783) over a 40-year period, from 1980 to 2020. Five-year overall survival (OS), recurrence-free survival (RFS), and clinicopathological characteristics were investigated. The prognosis of CD-CRC was further evaluated in groups divided by colon cancer and anorectal cancer (RC). Multivariable Cox regression analysis was used to adjust for confounding by unbalanced covariables.RESULTS:Compared with sporadic cases, patients with CD-CRC were younger; more often had RC, multiple lesions, and mucinous adenocarcinoma; and had lower R0 resection rates. Five-year OS was worse for CD-CRC than for sporadic CRC (53.99% vs 71.17%, P < 0.001). Multivariable Cox regression analysis revealed that CD was associated with significantly poorer survival (hazard ratio 2.36, 95% confidence interval: 1.54-3.62, P < 0.0001). Evaluation by tumor location showed significantly worse 5-year OS and RFS of CD-RC compared with sporadic RC. Recurrence was identified in 39.57% of CD-RC cases and was mostly local.DISCUSSION:Poor prognosis of CD-CRC is attributable primarily to RC and high local recurrence. Local control is indispensable to improving prognosis. |
| DOI | 10.14309/ajg.0000000000002269 |
| PMID | 36988310 |