title: Histomorphological features and prognosis of colitis-associated colorectal cancer in patients with primary sclerosing cholangitis.
abstract: BACKGROUND
  Histomorphology of colitis-associated colorectal cancer (CAC) in patients with primary sclerosing cholangitis (PSC) remains to be systemically characterized and prognosis in these patient needs to be further defined.
  
  
  OBJECTIVE
  To examine the impact of PSC on histomorphology and to assess prognosis of CAC-PSC patients.
  
  
  METHODS
  A cohort of CAC patients were identified from the Pathology Database (1994-2010) at Cleveland Clinic; histomorphological features and other relevant data were collected by retrospective review of pathology slides and medical records.
  
  
  RESULTS
  A total of 87 CAC patients were included, with 11 patients having PSC (the study group) and 76 patients without PSC (the control group). The overall median follow up was 6 (range: 0-20) years. The patients in the study group had a longer median duration of inflammatory bowel disease prior to CAC diagnosis (p = 0.046). In study group, seven (63.6%) patients had right-sided CAC (vs. 36.8% in the control group, p = 0.11). Background high-grade dysplasia was noted less (9.1% vs. 44.7%), while low-grade dysplasia was detected more in the study group (72.7% vs. 28.9%) (p = 0.02). All histomorphological features were comparable between groups. The overall survival (OS) and progression-free survival (PFS) showed no statistical difference between CAC patients with or without PSC. After excluding TNM stage IV patients, patients with PSC showed a trend toward shorter OS and PFS (p = 0.07 and p = 0.1).
  
  
  CONCLUSIONS
  In CAC, histomorphology appeared to be independent of PSC. PSC is associated with a trend toward shorter OS and PFS in CAC patients with stage I-III diseases.
authors.affiliation: Department of Geriatric Surgery, the Second Xiangya Hospital, Central South University , Changsha , China.
authors.forename: Ganglei
authors.initials: G
authors.lastname: Liu
authors.forename: Jingmei
authors.initials: J
authors.lastname: Lin
authors.forename: Hao
authors.initials: H
authors.lastname: Xie
authors.forename: Bo
authors.initials: B
authors.lastname: Shen
authors.forename: Luca
authors.initials: L
authors.lastname: Stocchi
authors.forename: Xiuli
authors.initials: X
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015209:Cholangitis, Sclerosing / Q000150:complications*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Crohn’s disease; colorectal cancer; inflammatory bowel disease; primary sclerosing cholangitis; prognosis; survival; ulcerative colitis