title: Colorectal carcinoma in inflammatory bowel disease: a comparison between Crohn's and ulcerative colitis.
abstract: OBJECTIVE
  The study assessed the clinicopathological features and survival rates of inflammatory bowel disease (IBD) patients with colorectal carcinoma (CRC), which accounts for ∼ 15% of all IBD associated death.
  
  
  METHODS
  The medical records of patients operated on for CRC in three institutions between 1992 and 2009 were reviewed, and those with Crohn's colitis (CC) and ulcerative colitis (UC) were identified. Data on age, gender, disease duration, colitis severity, surgical procedure, tumour stage and survival were retrieved.
  
  
  RESULTS
  Fifty-three patients (40 UC and 13 CC, 27 men, mean age at operation 54 years) were found. All parameters were comparable between the groups. Mean disease duration before CRC was 22.7 years for UC and 16.6 years for CC patients (P = 0.04). CRC was diagnosed preoperatively in 43 (81%) patients. Twenty-eight patients had colon cancer, 23 had rectal cancer and two patients had more than one cancer. All malignancies were located in segments with colitis. Over one-half were diagnosed at an advanced stage (36% stage III; 17% stage IV). At a mean follow up of 56 ± 65 months, 60% were alive (54% disease free) and 40% were dead from cancer-related causes. The 5-year survival rate was 61% for the UC and 37% for the CC patients (P = NS).
  
  
  CONCLUSIONS
  CRC in IBD patients is frequently diagnosed at an advanced stage, a factor that contributes to poor prognosis. The risk of CRC in CC patients is comparable to those with UC. Long-term surveillance is recommended for patients with long-standing CC and UC.
authors.affiliation: Division of Surgery B, Sackler Faculty of Medicine, Proctology Unit, Tel Aviv Sourasky Medical Center, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: F
authors.initials: F
authors.lastname: Averboukh
authors.forename: Y
authors.initials: Y
authors.lastname: Ziv
authors.forename: Y
authors.initials: Y
authors.lastname: Kariv
authors.forename: O
authors.initials: O
authors.lastname: Zmora
authors.forename: I
authors.initials: I
authors.lastname: Dotan
authors.forename: J M
authors.initials: JM
authors.lastname: Klausner
authors.forename: M
authors.initials: M
authors.lastname: Rabau
authors.forename: H
authors.initials: H
authors.lastname: Tulchinsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000473:pathology* / Q000628:therapy; D003093:Colitis, Ulcerative / Q000150:complications*; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy; D003424:Crohn Disease / Q000150:complications*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies