P101 Prevalence of Neoplasms and Their Relationship With the Treatment in Mexican Population With IBD in a Tertiary Care Hospital
Authors: Trujillo de la Fuente Korely , López Goméz Jesús , Cortes Espinosa Tomas , Ramos Gómez Mayra , Aleman Abitia Dassaev , Navarro Gerrard Christian , Ramirez del Pilar Rodolfo , Aguilar Hernandez Jhonatan , Klimek Albarrán Gabriel 
Published: December 2019

BACKGROUND:

Inflammatory bowel disease (IBD) is described as a group of conditions which are associated to chronic inflammation of the gastrointestinal tract, is divided into Crohn’s disease (CD) and Ulcerative Colitis (UC). Malignant tumours of the gastrointestinal tract and other extraintestinal neoplasms have been associated to this condition. Treatment for IBD is based on the use of immunosuppressants (azathioprine, 6-mercaptopurine and methotrexate), biological agents such as anti-tumor necrosis factor-α antibodies like infliximab, adalimumab, golimumab and antintegrines: natalizumab and vedolizumab. There is a growing concern about the potential association these medications have with the development of neoplasms.

METHODS:

A historical cohort of patients from the IBD clinic was analysed in the time frame corresponding from 1998 until 2018. Study: descriptive, retrospective and transversal. Relative and central frequency averages were used to obtain percentages, averages and standard deviation. Chi square test was used for qualitative variables and Student's T-test was used for continuous numerical quantitative variables. Risk calculation (OR) was made from cross tables to show the impact of the treatment on the appearance of neoplasms.

RESULTS:

A total of 103 patients with IBD were included, 69.9% had UC and 30.1% were diagnosed with CD. The prevalence of neoplasms was 13.6% of which 7 were of the colon, ([2] adenocarcinoma of the rectum, [1] adenocarcinoma of the right colon, [4] hyperplasic adenomas with dysplasia) and 7 extracolonic neoplasms ([2] basal cell carcinoma, [1] malignant melanoma, [1] renal cell carcinoma, [1] prostate adenocarcinoma, [1] thymoma, [1] liposarcoma) with a mean age of presentation of 49.5 ± 11.8 years in colon malignancy and 67.7 ± 12 years for extracolonic neoplasia with a P = 0.015. Colonic neoplasms were far more predominant in the female population (71.4%) and extracolonic neoplasms were predominant in the male population (57.1%). Both extracolonic (57.1%) and colonic neoplasms (71.4%) were more prevalent in the population with UC. The group under treatment with biologic agents combined with other medications (steroids and mesalazine) corresponded to 41.9% of the extracolonic neoplasms and 19.4% for colonic neoplasms with a significant P (P = <0.001). The medium time of presentation for colonic neoplasms was of 9.14 ± 5.14 years and 5.43 ± 2.76 years for extracolonic neoplasms. There was no statistical significance in the risk calculation (OR) which measured the impact of treatment on the occurrence of neoplasms.

CONCLUSION(S):

The total prevalence of neoplasms in patients with IBD analysed in this investigation was of 13.6%. Colonic and extracolonic neoplasms were more prevalent in the UC group. Colonic neoplasms appearance time did not vary with respect to international reports yet in our study we found that extracolonic neoplasms appeared before in comparison to the international literature for which earlier screening programs could be considered once treatment for the IBD has begun. Due to the small sample size, a prospective randomized study to confirm these findings is needed. This work has no conflict of interest.