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Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study.
Seishima, Ryo; Okabayashi, Koji; Ikeuchi, Hiroki; Uchino, Motoi; Futami, Kitaro; Noguchi, Tatsuki; Ohge, Hiroki; Iseki, Yasuhito; Watanabe, Kazuhiro; Itabashi, Michio; Okamoto, Kinya; Toiyama, Yuji; Ogino, Takayuki; Nakamura, Masafumi; Yamada, Kazutaka; Wakai, Toshifumi; Sato, Yu; Kimura, Hideaki; Takahashi, Kenichi; Hida, Koya; Kinugasa, Yusuke; Ishida, Fumio; Okuda, Junji; Daito, Koji; Koyama, Fumikazu; Ueno, Hideki; Yamamoto, Takayuki; Yamamoto, Seiichiro; Hanai, Tsunekazu; Maemoto, Atsuo; Arakaki, Junya; Komori, Koji; Akagi, Yoshito; Shida, Dai; Yamaguchi, Shigeki; Matsuda, Keiji; Maeda, Kiyoshi; Noake, Toshihiro; Nezu, Riichiro; Sasaki, Shin; Hasegawa, Junichi; Sunami, Eiji; Kanemitsu, Yukihide; Katsumata, Kenji; Uehara, Kei; Kiyomatsu, Tomomichi; Suto, Takeshi; Kazama, Shinsuke; Yamada, Takeshi; Goi, Takenori.
Affiliation
  • Seishima R; Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
  • Okabayashi K; Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
  • Ikeuchi H; Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Hyogo, Japan.
  • Uchino M; Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Hyogo, Japan.
  • Futami K; Department of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
  • Noguchi T; Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
  • Ohge H; Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan.
  • Iseki Y; Surgical Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Watanabe K; Department of Surgery, Tohoku University School of Medicine, Miyagi, Japan.
  • Itabashi M; Department of Surgery, Division of Inflammatory Bowel Disease Surgery, Tokyo Women's Medical University, Tokyo, Japan.
  • Okamoto K; Japan Community Health Care Organization, Tokyo Yamate Medical Center, Tokyo, Japan.
  • Toiyama Y; Department of Gastrointestinal and Paediatric Surgery, Mie University Graduate School of Medicine, Mie, Tokyo.
  • Ogino T; Department of Gastrointestinal Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
  • Nakamura M; Kyushu University Department of Surgery and Oncology, Graduate School of Medical Sciences, Fukuoka, Japan.
  • Yamada K; Takano Hospital, Coloproctology Center, Kumamoto, Japan.
  • Wakai T; Division of Digestive and General Surgery, Niigata University, Niigata, Japan.
  • Sato Y; Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan.
  • Kimura H; Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Kanagawa, Japan.
  • Takahashi K; Inflammatory Bowel Disease Center, Tohoku Rosai Hospital, Miyagi, Japan.
  • Hida K; Department of Gastrointestinal Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
  • Kinugasa Y; Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
  • Ishida F; Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
  • Okuda J; Cancer Center, Osaka Medical and Pharmaceutical University, Osaka, Japan.
  • Daito K; Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan.
  • Koyama F; Department of Surgery, Nara Medical University, Nara, Japan.
  • Ueno H; Department of Surgery, National Defense Medical College, Saitama, Japan.
  • Yamamoto T; Japan Community Health Care Organization, Yokkaichi Hazu Medical Center, Mie, Japan.
  • Yamamoto S; Department of Digestive System Surgery, Tokai University School of Medicine, Kanagawa, Japan.
  • Hanai T; Department of Surgery, School of Medicine, Fujita Health University, Aichi, Japan.
  • Maemoto A; Institute of Biomedical Research, Sapporo-Higashi Tokushukai Hospital, Hokkaido, Japan.
  • Arakaki J; Department of Surgery, Center for Gastroenterology, Urasoe General Hospital Okinawa, Japan.
  • Komori K; Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.
  • Akagi Y; Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan.
  • Shida D; Department of Surgery, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
  • Yamaguchi S; Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
  • Matsuda K; Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
  • Maeda K; Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.
  • Noake T; Kurume Coloproctology Center, Fukuoka, Japan.
  • Nezu R; Department of Surgery, Nishinomiya Municipal Central Hospital, Hyogo, Japan.
  • Sasaki S; Department of Coloproctological Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
  • Hasegawa J; Department of Surgery, Osaka Rosai Hospital, Osaka, Japan.
  • Sunami E; Department of Surgery, Kyorin University, Tokyo, Japan.
  • Kanemitsu Y; Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
  • Katsumata K; Department of Gastrointestinal and Paediatric Surgery, Tokyo Medical University, Tokyo, Japan.
  • Uehara K; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan.
  • Kiyomatsu T; Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan.
  • Suto T; Department of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
  • Kazama S; Division of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan.
  • Yamada T; Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
  • Goi T; First Department of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Am J Gastroenterol ; 118(7): 1248-1255, 2023 07 01.
Article in En | MEDLINE | ID: mdl-36622356
ABSTRACT

INTRODUCTION:

The aim of this study was to evaluate the effect of biologics on the risk of advanced-stage inflammatory bowel disease (IBD)-associated intestinal cancer from a nationwide multicenter data set.

METHODS:

The medical records of patients with Crohn's disease (CD) and ulcerative colitis (UC) diagnosed with IBD-associated intestinal neoplasia (dysplasia or cancer) from 1983 to 2020 were included in this study. Therapeutic agents were classified into 3 types biologics, 5-aminosalicylic acid, and immunomodulators. The pathological cancer stage was compared based on the drug used in both patients with CD and UC.

RESULTS:

In total, 1,042 patients (214 CD and 828 UC patients) were included. None of the drugs were significantly associated with cancer stage in the patients with CD. In the patients with UC, an advanced cancer stage was significantly associated with less use of biologics (early stage 7.7% vs advanced stage 2.0%, P < 0.001), 5-aminosalicylic acid, and immunomodulators. Biologic use was associated with a lower incidence of advanced-stage cancer in patients diagnosed by regular surveillance (biologics [-] 24.5% vs [+] 9.1%, P = 0.043), but this was not the case for the other drugs. Multivariate analysis showed that biologic use was significantly associated with a lower risk of advanced-stage disease (odds ratio = 0.111 [95% confidence interval, 0.034-0.356], P < 0.001).

DISCUSSION:

Biologic use was associated with a lower risk of advanced IBD-associated cancer in patients with UC but not with CD. The mechanism of cancer progression between UC and CD may be different and needs to be further investigated.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Biological Products / Inflammatory Bowel Diseases / Colitis, Ulcerative / Crohn Disease / Intestinal Neoplasms Type of study: Clinical_trials / Diagnostic_studies / Etiology_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Gastroenterol Year: 2023 Document type: Article Affiliation country:
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Biological Products / Inflammatory Bowel Diseases / Colitis, Ulcerative / Crohn Disease / Intestinal Neoplasms Type of study: Clinical_trials / Diagnostic_studies / Etiology_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Gastroenterol Year: 2023 Document type: Article Affiliation country: