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• W3118834621 abstract "BACKGROUND: Anal lesions in cases of Crohn’s disease can give rise to adenocarcinoma of the anal canal; however, the oncologic outcomes in these patients have not yet been thoroughly investigated. OBJECTIVE: This study aimed to clarify the influence of Crohn’s disease on the oncologic outcomes in patients with adenocarcinoma of the anal canal. DESIGN: This was a retrospective observational study from a prospectively collected database. SETTINGS: The study was conducted at a single institution. PATIENTS: This study included 102 patients with adenocarcinoma of the anal canal, including 34 (33.3%) with Crohn’s disease–associated lesions and 68 (66.7%) with non-Crohn’s disease–associated lesions. MAIN OUTCOME MEASURES: Prognostic factors were detected using a Cox regression analysis, and the oncologic outcomes were calculated using the Kaplan–Meier method. RESULTS: Crohn’s disease–associated patients were significantly younger (45 vs 62 y; p < 0.001), had a high incidence of external/anal gland-type disease (61.8% vs 5.9%, p < 0.001) and had large tumors (7.1 ± 3.0 vs 4.7 ± 2.3 cm; p = 0.03) in comparison with non-Crohn’s disease–associated patients. A Cox regression analysis showed that an advanced clinical T stage (T3 or T4; tumor size ≥5 cm) was an independent risk factor for 5-year local recurrence-free survival (HR = 3.49; p = 0.04), disease-free survival (HR = 2.82; p = 0.008), and overall survival (HR = 2.92; p = 0.006), and Crohn’s disease association was an independent prognostic factor for local recurrence-free survival (HR = 2.29; p = 0.04) and overall survival (HR = 2.86; p = 0.04). The oncologic outcomes of patients who had the 2 abovementioned negative factors (cT3,4 Crohn’s disease–associated patients) were significantly poorer than those of T3,4 non-Crohn’s disease–associated patients (5-year local recurrence-free survival: 32.5% vs 70.4%, p = 0.001; disease-free survival: 15.9% vs 40.7%, p = 0.04; overall survival: 25.8% vs 71.0%, p = 0.007). LIMITATIONS: This was a single-arm, retrospective study. CONCLUSIONS: Significantly poorer oncologic outcomes were confirmed in Crohn’s disease–associated patients with large tumors. Thus, it is important to perform careful surveillance of anal lesions in patients with Crohn’s disease while taking these facts into consideration. See Video Abstract at http://links.lww.com/DCR/B449. RESULTADOS ONCOLÓGICOS ADVERSOS DEL ADENOCARCINOMA DEL CANAL ANAL EN PACIENTES CON ENFERMEDAD DE CROHN ANTECEDENTES: Las lesiones anales en casos de enfermedad de Crohn pueden dar lugar a un adenocarcinoma del canal anal; sin embargo, los resultados oncológicos en estos pacientes aún no se han investigado a fondo. OBJETIVOS: Este estudio tuvo como objetivo aclarar la influencia de la enfermedad de Crohn en los resultados oncológicos en pacientes con adenocarcinoma del canal anal. DISEÑO: Estudio observacional retrospectivo de una base de datos recopilada prospectivamente. ENTORNO CLINICO: El estudio se realizó en una sola institución. PACIENTES: Este estudio incluyó 102 pacientes con adenocarcinoma del canal anal, incluidos 34 (33,3%) con lesiones asociadas a la enfermedad de Crohn y 68 (66,7%) con lesiones no asociadas a la enfermedad de Crohn. PRINCIPALES MEDIDAS DE VOLARACION: Los factores pronósticos se detectaron mediante un análisis de regresión de Cox y los resultados oncológicos se calcularon utilizando el método de Kaplan-Meier. RESULTADOS: Los pacientes asociados a la enfermedad de Crohn eran significativamente más jóvenes (45 versus a 62 años, p <0,001), tenían una alta incidencia de enfermedad de tipo glandular externo/ anal (61,8% versus a 5,9%, p <0,001) y tumores grandes (7,1 ± 3,0 cm versus a 4,7 ± 2,3 cm, p = 0,03) en comparación con los pacientes no asociados a la enfermedad de Crohn. Un análisis de regresión de Cox mostró que un estadío clínico T avanzado (T3,4; tamaño del tumor ≥5 cm) era un factor de riesgo independiente para la supervivencia sin recidiva local ( SLF ) a 5 años (índice de riesgo [ HR ]: 3,49, p = 0,04), supervivencia libre de enfermedad ( SSE ) ( HR : 2,82, p = 0,008) y supervivencia general (SG) ( HR : 2,92, p = 0,006), y la enfermedad de Crohn asociada fue un factor pronóstico independiente para la SLF (HR : 2,29, p = 0,04) y SG ( HR : 2,86, p = 0,04). Los resultados oncológicos de los pacientes que tenían los dos factores negativos mencionados anteriormente (pacientes asociados con la enfermedad de Crohn cT3,4) fueron significativamente peores que los de los pacientes no asociados con la enfermedad de Crohn con T3,4 ( LFS a 5 años: 32,5% versus a 70,4 %, p = 0,001; SSE: 15,9% versus a 40,7%, p = 0,04; SG: 25,8% versus a 71,0%, p = 0,007). LIMITACIONES: Un estudio retrospectivo de un solo brazo. CONCLUSIONES: Se confirmaron resultados oncológicos significativamente peores en pacientes asociados con la enfermedad de Crohn con tumores grandes. Por lo tanto, es importante realizar una vigilancia cuidadosa de las lesiones anales en pacientes con enfermedad de Crohn. Consulte Video Resumen en http://links.lww.com/DCR/B449." @default.
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• W3118834621 date "2020-12-17" @default.
• W3118834621 modified "2023-10-16" @default.
• W3118834621 title "Adverse Oncologic Outcomes of Adenocarcinoma of the Anal Canal in Patients With Crohn’s Disease" @default.
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• W3118834621 doi "https://doi.org/10.1097/dcr.0000000000001874" @default.
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