Colorectal cancer in Crohn’s colitis is comparable to sporadic colorectal cancer

Jochen K. Lennerz, Kimberley W.J. van der Sloot, Long Phi Le, Julie M. Batten, Jae Young Han, Kenneth C. Fan, Corey A. Siegel, Amitabh Srivastava, Do Youn Park, Jey Hsin Chen, Bruce E. Sands, Joshua R. Korzenik, Robert D. Odze, Dora Dias-Santagata, Darrell R. Borger, Hamed Khalili, A. John Iafrate, Gregory Y. Lauwers

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Purpose: It is now recognized that Crohn’s disease (CD), similar to ulcerative colitis (UC), carries an up to 20-fold higher cancer risk, and the development of colorectal carcinoma (CRC) is a major long-term complication. Once CRC is present, molecular profiling is one of the components in selecting appropriate treatment strategies; however, in contrast to UC, genetic alterations in Crohn’s colitis-associated CRC are poorly understood. Methods: In a series of 227 patients with Crohn’s colitis, we identified 33 cases of CRC (~14 %) and performed targeted mutational analysis of BRAF/KRAS/NRAS and determined microsatellite status as well as immunophenotype of the tumors. Results: In the CRC cohort, the median age at time of cancer diagnosis was 58 (range 34–77 vs. 59.5 in sporadic; P = 0.81) and the median CD duration was 29 years (range 6–45). As a group, CRC complicating Crohn’s colitis is BRAF (97 %) and NRAS (100 %) wild type and the vast majority is microsatellite stable (94 %); KRAS-mutations were found in six cases (18 %). Stage grouping, anatomic distribution, and overall survival were similar to sporadic CRC; however, long-standing CD (≥25 years) as well as gastric-immunophenotype (MUC5AC+) was associated with significantly shorter overall survival (P = 0.0029; P = 0.036, respectively). Conclusion: In summary, the clinicopathological and molecular profile of CD-associated CRC is similar to that observed in sporadic CRC.

Original languageEnglish
Pages (from-to)973-982
Number of pages10
JournalInternational Journal of Colorectal Disease
Volume31
Issue number5
DOIs
StatePublished - 1 May 2016

Keywords

  • Colorectal cancer
  • Crohn’s colitis
  • SNaPshot
  • Targeted re-sequencing

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