title: Clinical outcome of IBD-associated versus sporadic colorectal cancer: a matched-pair analysis.
abstract: OBJECTIVE
  This study assesses the perioperative course and long-term survival of inflammatory bowel disease (IBD)-associated vs. sporadic colorectal cancer (IBD-CRC vs. SCRC) after elimination of known confounders.
  
  
  METHODS
  Between 1991 and 2007, n = 3,299 patients underwent surgery for CRC at our institution. Thirty-three IBD patients were identified and compared to 165 SCRC using a matched-pair analysis (1:5 scenario). As matching parameters were used: age, gender, Union Internationale Contre le Cancer (UICC) stage, site of primary lesion, and date of surgery. After univariate analysis of the perioperative course, a multivariate survival analysis (Cox) of all patients (n = 198) was performed.
  
  
  RESULTS
  Significant differences were shown for preoperative symptoms (p = 0.022), transfusion rate (p = 0.01), ileostomy construction rate (p = 0.001), total complication rate (p = 0.042), and hospital stay (15 vs. 11 days, p < 0.001). Local tumor recurrence was three times higher in IBD-CRC (p = 0.004), and the 5-year survival rate was lower (49 % vs. 67 %, p = 0.03). IBD, advanced UICC stage, and synchronous liver metastasis were identified as independent prognostic factors.
  
  
  CONCLUSIONS
  We demonstrate for the first time survival differences between IBD-CRC and SCRC after elimination of five known confounders. This might be caused by a difference in tumor biology resulting in a higher local recurrence rate in IBD-CRC.
authors.affiliation: Department of Surgery, University of Munich, Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Bernhard W
authors.initials: BW
authors.lastname: Renz
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Thasler
authors.forename: Gerhard
authors.initials: G
authors.lastname: Preissler
authors.forename: Tobias
authors.initials: T
authors.lastname: Heide
authors.forename: Philippe N
authors.initials: PN
authors.lastname: Khalil
authors.forename: Michael
authors.initials: M
authors.lastname: Mikhailov
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Martin E
authors.initials: ME
authors.lastname: Kreis
authors.forename: Markus
authors.initials: M
authors.lastname: Rentsch
authors.forename: Axel
authors.initials: A
authors.lastname: Kleespies
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome