Prognosis and molecular characteristics of IBD-associated colorectal cancer: Experience from a French tertiary-care center

Background: Little is known about the prognosis of colorectal cancer associated with inflammatory bowel disease (CRC-IBD) in a real-world cohort in France.Methods: We conducted a retrospective observational study including all patients presenting CRC-IBD in a French tertiary center. Results: Among 6510 patients, the rate of CRC was 0.8% with a median delay of 19.5 years after IBD diagnosis (median age 46 years, ulcerative colitis 59%, initially localized tumor 69%). There was a previous exposure to immunosuppressants (IS) in 57% and anti-TNF in 29% of the cases. A RAS mutation was observed in only 13% of metastatic patients. OS of the whole cohort was 45 months. OS and PFS of synchronous metastatic patients was 20.4 months and 8.5 months respectively. Among the patients with localized tumor those previously exposed to IS had a better PFS (39 months vs 23 months; p = 0.05) and OS (74 vs 44 months; p = 0.03). The IBD relapse rate was 4%. No unexpected chemotherapy side-effect was observedConclusions: OS of CRC-IBD is poor in metastatic patients although IBD is not associated with underexposure or increased toxicity to chemotherapy. Previous IS exposure may be associated with a better prognosis.& COPY; 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Automated summary

This retrospective study in France investigated the prognosis of CRC-IBD and found a relatively low rate of CRC in IBD patients (0.8%) with a median delay of 19.5 years. The overall survival (OS) of the cohort was 45 months, and the OS of metastatic patients was only 20.4 months. Previous exposure to immunosuppressants may be associated with a better prognosis.