title: A matched case-control study of IBD-associated colorectal cancer: IBD portends worse outcome.
abstract: OBJECTIVE
  The effect of inflammatory bowel disease (IBD) on outcome in patients with colorectal cancer (CRC) remains unclear. Our objective is to evaluate oncologic outcomes of patients with IBD-associated CRC.
  
  
  METHODS
  We retrospectively reviewed a prospectively maintained database to identify patients with IBD-associated CRC. Clinicopathologic variables and overall survival were compared to patients with sporadic CRC using a 2:1 matched-controlled analysis.
  
  
  RESULTS
  Fifty-five patients with IBD and CRC were identified. On univariate analysis, CRC patients with IBD had a significantly shorter median overall survival (68.2 months vs. 204.3 months, P = 0.01) compared to patients with sporadic CRC. On multivariate analysis, after adjusting for N and M stage, IBD was associated with an increased risk of death compared to sporadic CRC (HR = 2.011, 95% CI 1.24-3.23, P = 0.004). Stage 3 CRC patients with IBD in particular showed significantly decreased survival (23.0 vs. 133.9 months, P = 0.008).
  
  
  CONCLUSIONS
  In this study, patients with node-positive IBD-associated CRC had a significant increased risk of death and a shorter overall survival than those with sporadic disease and may require tailored adjuvant therapy and surveillance protocols. Continued investigation to elucidate the mechanisms that contribute to these observations is justified.
authors.affiliation: Department of Surgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Hrabe
authors.forename: John C
authors.initials: JC
authors.lastname: Byrn
authors.forename: Anna M
authors.initials: AM
authors.lastname: Button
authors.forename: Gideon K
authors.initials: GK
authors.lastname: Zamba
authors.forename: Muneera R
authors.initials: MR
authors.lastname: Kapadia
authors.forename: James J
authors.initials: JJ
authors.lastname: Mezhir
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000150:complications* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult
keywords: colorectal cancer; inflammatory bowel disease; matched controlled study