In:
Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 276, No. 5 ( 2022-11), p. e319-e330
Abstract:
The aim of our study was to conduct a systematic review and meta-analysis comparing the survival outcomes of IBD-associated and non-IBD-associated CRC. Summary of Background Data: Investigations comparing the prognosis in CRC patients with and without IBD have yielded conflicting results. Methods: PubMed/MEDLINE, Embase, Web of Science, Cochrane Library were searched for studies evaluating the prognostic outcomes between CRC patients with IBD and those without IBD. Estimates of survival-related outcomes and clinicopathological features in IBD-CRC and non-IBD CRC were pooled through random-effects or fix-effects models. The study is registered with PROSPERO, CRD42021261513. Results: Of 12,768 records identified, twenty-five studies with 8034 IBD-CRC and 810,526 non-IBD CRC patients were included in the analysis. IBD-CRC patients have a significant worse overall survival (OS) with the hazard ratio (HR) of 1.33 [95% confidence interval (CI): 1.20–1.47] than those without IBD. Pooled estimates of cancer-specific survival demonstrated that IBD-CRC patients had a poorer cancer-specific survival than those without IBD with fixed-effect model (HR, 2.17; 95% CI: 1.68–2.78; P 〈 0.0001). Moreover, ulcerative colitis-associated CRC patients have favorable OS than Crohn’s disease-associated CRC (HR 0.79,95% CI: 0.72–0.87). Compared to non-IBD-CRC, patients with IBD-associated CRC are characterized by an increased rate of poor differentiation (OR 2.02, 95% CI: 1.57–2.61), mucinous or signet ring cell carcinoma (OR 2.43, 95% CI: 1.34–4.42), synchronous tumors (OR 3.18, 95% CI: 2.26–4.47), right-sided CRC (OR 1.62, 95%CI: 1.05–2.05), male patients (OR 1.10, 95% CI: 1.05–1.16), and a reduced rate of R0 resections (OR 0.60, 95% CI: 0.44–0.82). Conclusions: IBD-CRC patients have a significant worse OS than patients with non-IBD CRC, which may be attributed to more aggressive histological characteristics and a lower rate of R0 resections at the primary tumor site. Optimized therapeutic standards and tailored follow-up strategies might improve the prognosis of IBD-CRC patients.
Type of Medium:
Online Resource
ISSN:
0003-4932
DOI:
10.1097/SLA.0000000000005339
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2002200-1
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