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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.

on behalf of the Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon and Rectum INTRODUCTION: Colorectal cancer (CRC) is one of the major life-threatening complications in patients with Crohn's disease (CD). Previous studies of CD-associated CRC (CD-CRC) have involved only small numbers of patients, and no large series have been reported from Asia. The aim of this study was to clarify the prognosis and clinicopathological features of CD-CRC compared with sporadic CRC. METHODS:A large nationwide database was used to identify patients with CD-CRC (n 5 233) and sporadic CRC (n 5 129,783) over a 40-year period, from 1980 to 2020. Five-year overall survival (OS), recurrence-free survival (RFS), and clinicopathological characteristics were investigated. The prognosis of CD-CRC was further evaluated in groups divided by colon cancer and anorectal cancer (RC). Multivariable Cox regression analysis was used to adjust for confounding by unbalanced covariables.

We report a rare case of ileal duplication with diverticulitis. A 46-year-old woman presented with right lower abdominal pain, and was referred to our hospital because of suspected colonic diverticulitis. Abdominal CT scan showed a bowel wall thickening suggestive of diverticulitis and an increase in the concentration of fat tissue surrounding the intestine. Continuity between the lesion and the surrounding intestinal tract could not be confirmed. Furthermore, the blood supply to the lesion was from the superior mesenteric artery branches, which led to the suspicion of ileal duplication. We performed a single-incision laparoscopic partial ileal resection. The duplicated tract was 12×5 cm with wall thickening, and was located 45 cm from the terminal ileum on the mesenteric side. Histopathological examination revealed that the duplicated tract showed the ileal mucosa and muscle layer to be without atypia, and a diverticulum with partial acute inflammation, confirming the diagnosis of diverticulitis of the duplicated ileum. To the best of our knowledge, there have been no reports of ileal duplication with diverticulitis so far, and we believe this is a rare case.