title: Chemotherapy Tolerance and Oncologic Outcomes in Patients With Colorectal Cancer With and Without Inflammatory Bowel Disease.
abstract: Inflammatory bowel disease (IBD), comprising Crohn disease and ulcerative colitis, is a risk factor for colorectal cancer (CRC). Chemotherapy toxicity may exacerbate IBD symptoms and vice versa, but data are limited. We evaluated chemotherapy tolerance and oncologic outcomes in patients with CRC with and without IBD.
  
  
  
  Medical records of patients with CRC with and without IBD treated between 2008 and 2013 were reviewed. Where possible, patients were matched by age, sex, stage, and diagnosis year. Chemotherapy tolerance and survival outcomes were compared between patients with IBD and without IBD.
  
  
  
  A total of 158 subjects with CRC were included: 80 patients had IBD and 78 matched control patients did not have IBD. Between cases and controls, there were no significant differences in demographic data, stage of CRC, and cancer treatments, with equivalent numbers of patients receiving surgery, radiation, and chemotherapy. Patients with IBD experienced more CRC treatment alterations than those without IBD (74% vs. 44%, P = .03), largely due to a higher frequency of treatment delays among patients with IBD. Differences in stage-specific 5-year overall survival (OS) and recurrence-free survival (RFS) in patients with and without IBD were not significant, except for stage IV patients with IBD who had significantly shorter OS than those without IBD. Patients with histologically active IBD did not require more chemotherapy alterations than patients with inactive IBD.
  
  
  
  In this series, patients with CRC with IBD experienced more treatment alterations (mostly delays) than those without IBD. Patients with stage IV CRC with IBD had shorter survival than patients without IBD.
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, NY. Electronic address: ja3064@cumc.columbia.edu.
authors.forename: Jordan
authors.initials: J
authors.lastname: Axelrad
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Anuja
authors.initials: A
authors.lastname: Kriplani
authors.affiliation: Population Health Science and Policy, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Umut
authors.initials: U
authors.lastname: Ozbek
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY; Department of Pathology, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Noam
authors.initials: N
authors.lastname: Harpaz
authors.affiliation: Division of Gastroenterology, Department of Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Jean-Frederic
authors.initials: JF
authors.lastname: Colombel
authors.affiliation: Division of Gastroenterology, Department of Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Steven
authors.initials: S
authors.lastname: Itzkowitz
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Randall F
authors.initials: RF
authors.lastname: Holcombe
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Celina
authors.initials: C
authors.lastname: Ang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D013505:Digestive System Surgical Procedures; D018572:Disease-Free Survival; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy treatment alteration; Crohn disease; Overall survival; Recurrence-free survival; Ulcerative colitis