Background mucosal inflammation affects colorectal cancer prognosis in ulcerative colitis: a nationwide, multicenter study

作者：Akiyoshi Ikebata, Koji Okabayashi, Motoi Uchino, Hiroki Ikeuchi, Kohei Shigeta, Shiro Oka, Kitaro Futami, Michio Itabashi, Kazuhiro Watanabe, Masatsune Shibutani, Yoshiki Okita, Toshifumi Wakai, Yusuke Mizuuchi, Kinya Okamoto, Kazutaka Yamada, Yu Sato, Takayuki Ogino, Hideaki Kimura, Kenichi P. Takahashi, Koya Hida, Yusuke Kinugasa, Fumio Ishida, Junji Okuda, Koji Daito, Takayuki Yamamoto, Seiichiro Yamamoto, Fumikazu Koyama, Tsunekazu Hanai, Koji Komori, Dai Shida, Junya Arakaki, Yoshito Akagi, Shigeki Yamaguchi, Hideki Ueno, Keiji Matsuda, Atsuo Maemoto, Riichiro Nezu, Shin Sasaki, Eiji Sunami, Kiyoshi Maeda, Toshihiro Noake, Junichi Hasegawa, Yukihide Kanemitsu, Kenji Katsumata, Kay Uehara, Tomomichi Kiyomatsu, Takeshi Suto, Shinsuke Kazama, Takeshi Yamada, Takanori Goi, Tatsuki Noguchi, Soichiro Ishihara, Yoichi Ajioka, Kenichi Sugihara · 发表于：Journal of Crohn s and Colitis · 年份：2025 · DOI：10.1093/ecco-jcc/jjaf207 · 被引用次数：2 · 研究领域：Inflammatory Bowel Disease、Microscopic Colitis、Inflammatory Biomarkers in Disease Prognosis

BACKGROUND AND AIMS: Chronic background mucosal inflammation contributes to colorectal cancer (CRC) development in ulcerative colitis (UC), but its prognostic impact is unclear. We evaluated whether background mucosal inflammation documented at cancer diagnosis is associated with oncologic outcomes. METHODS: This retrospective study analyzed 1189 UC patients diagnosed with CRC using a nationwide, multicenter database in Japan. Patients were classified as CRC within the UC-involved area (within-area) or outside the UC-involved area (outside-area), based on tumor location relative to the UC disease extent documented endoscopically at cancer diagnosis. The primary end point was 5-year recurrence-free survival (RFS), and the secondary end point was 5-year cancer-specific survival (CSS). In within-area cases, inflammation severity was assessed using the Mayo Endoscopic Score (MES), stratified as Inactive, Mild-Moderate, and Severe. RESULTS: Of the 723 eligible patients, 683 had within-area and 40 outside-area CRC. Five-year RFS was significantly lower in within-area than outside-area CRCs (75.1% vs 87.6%, P = 0.022). Multivariable Cox regression analysis of RFS revealed this classification as an independent prognostic factor (hazard ratio = 2.99, 95% confidence interval: 1.09-8.18, P = 0.030). A significant difference was also observed in 5-year CSS (P = 0.038). Among within-area cases, higher MES was associated with stepwise declines in RFS (P = 0.150), and a similar, statistical...