The prognosis of colorectal cancer liver metastases associated with inflammatory bowel disease: An exploratory analysis

J Surg Oncol. 2018 Dec;118(7):1074-1080. doi: 10.1002/jso.25251. Epub 2018 Sep 27.

Abstract

Background and objectives: In contrast with sporadic colorectal cancer liver metastases (CRLM), inflammatory bowel disease (IBD)-related CRLM have not been studied to date.

Methods: Patients who underwent resection for IBD-related and sporadic CRLM from 2000 to 2015 were identified from an international registry and matched for pertinent prognostic variables. Overall survival (OS) and recurrence-free survival (RFS) were subsequently assessed.

Results: Twenty-eight patients had IBD-related CRLM. Synchronous extrahepatic disease was more common in IBD-related CRLM patients than patients with sporadic CRLM (28.6% vs 8.3%; P < 0.001), most commonly located in the lungs. In multivariable analysis, IBD did not have a significant influence on OS ( P = 0.835), and had a hazard ratio (HR) close to 1 (HR, 0.95; 95% confidence interval [CI], 0.57-1.57). IBD was also not associated with inferior RFS (HR, 1.07; 95%CI, 0.68-1.68; P = 0.780). Among patients with IBD-related CRLM, 9(50%) had isolated intrahepatic recurrence and 8(44.4%) isolated extrahepatic recurrence, while only 1(5.6%) developed combined recurrence. Of those who experienced recurrence after resection of IBD-related CRLM, 10 had their recurrence treated with curative intent.

Conclusions: Patients with IBD-related CRLM had similar survival compared with patients with sporadic CRLM, even though they more often present with extrahepatic disease. In addition, patients with IBD-related CRLM may experience patterns of recurrence different from patients with sporadic CRLM.

Keywords: colorectal liver metastases (CRLM); inflammatory bowel disease (IBD); overall survival (OS); recurrence.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Colorectal Neoplasms / pathology*
  • Europe / epidemiology
  • Female
  • Follow-Up Studies
  • Hepatectomy
  • Humans
  • Inflammatory Bowel Diseases / epidemiology*
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy
  • Lung Neoplasms
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Mutation
  • Neoplasm Recurrence, Local
  • Pancreatic Neoplasms
  • Peritoneal Neoplasms
  • Prognosis
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Retrospective Studies
  • United States / epidemiology

Substances

  • KRAS protein, human
  • Proto-Oncogene Proteins p21(ras)