SURVIVAL WITH COLORECTAL-CANCER IN ULCERATIVE-COLITIS - A STUDY OF 102 CASES

Objective This study was undertaken to correlate postoperative surviva l of patients with ulcerative colitis associated colorectal cancer wit h the stage, configuration, size, and mucin content of the tumor Summa ry Background Data The factors influencing prognosis in colorectal can cer in the general population are well accepted, but less is known abo ut their influence in cases of colorectal cancer associated with ulcer ative colitis. Methods The authors reviewed the records of 102 patient s with ulcerative colitis-associated colorectal cancer admitted to The Mount Sinai Hospital between 1959 and 1988 Tumors were classified on independent pathologic review according to histologic stage, configura tion, size, and mucin content. Comparisons among survival curves were tested by the generalized Wilcoxon test. Cox regression models were us ed to examine the joint effects of selected clinicopathologic features on postoperative survival rates. Results Complete follow-up was obtai ned for 93 patients (92%). Overall 5-year actuarial survival was 52%. When factors were analyzed one at a time, survival was significantly p oorer among patients with advanced cancer stage, larger tumor size, in filtrating and ulcerating configuration, and high mucin concentration. On multivariate analysis by the Cox regression model, however only ca ncer stage emerged as a factor independently predicting survival. Conc lusions For colitis-associated colorectal cancers, as for noncolitic c ancers, histologic stage is the most important variable determining po stoperative survival. The distribution of stages in our series and the survival rates within each stage did not differ appreciably from the distributions and survival rates reported for noncolitic colorectal ca ncers.