Inflammatory Bowel Disease (IBD) is a Risk Factor for Extrahepatic Cholangiocarcinoma (ECC) in Subjects Without Underlying Primary Sclerosing Cholangitis.

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Presentation transcript:

Inflammatory Bowel Disease (IBD) is a Risk Factor for Extrahepatic Cholangiocarcinoma (ECC) in Subjects Without Underlying Primary Sclerosing Cholangitis (PSC) Hassan M. Ghoz1, Esha Baichoo1, Benyam Addissie 1, Lewis R. Roberts1, Roongruedee Chaiteerakij2 1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA 2Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand Background Cohort’s Baseline Characteristics Multivariate Analysis of Potential Risk Factors for pCCA Summary and Conclusions Evidence for a discrete role of IBD in the pathogenesis of CCA is scant. It remains unclear whether IBD is an independent risk factor for CCA as the concurrent diagnosis of PSC has not been clearly reported in most studies assessing the effect of IBD on CCA risk. No studies have focused solely on the relationship of ECC to IBD in subjects without PSC. Variables pCCA dCCA Cases (n=411) Controls (n=808) (n=103) (n=204) Age, years 65.8 ± 12.0 66.0 ± 11.9 67.4 ± 11.1 67.4 ±10.9 Male, n (%) 231 (56.2) 453 (56.1) 65 (63.1) 127 (62.2) White, n (%) 351 (92.1) 706 (88.3) 93 (95.9) 187 (91.7) Risk factors, n (%) Smoking 205 (50.1) 329 (41.2) 65 (63.7) 84 (41.6) Alcohol 220 (60.9) 628 (78.2) 67 (73.7) 158 (77.5) Diabetes 67 (16.3) 91 (11.5) 23 (22.3) 26 (12.9) BMI (>30Kg/m2) 117 (28.7) 196 (25.7) 32 (31.4) 66 (33.3) Inflammatory Bowel Disease (Combined) 17 (4.14) 14 (1.7) 6 (5.8) 1 (0.5) Ulcerative Colitis 10 (2.4) 9 (1.1) 4 (3.9) 0 (0) Crohn’s Disease 7 (1.7) 5 (0.6) 2 (1.9) Cirrhosis 9 (2.2) 4 (0.5) HCV 3 (0.4) 2 (1.0) HBV 3 (0.7) Incidental Asymptomatic Gallstones 61 (14.8) 19 (2.4) 12 (11.7) 5 (2.5) Cholecystectomy for Gallstones 109 (20.8) 109 (10.6) 26 (23.2) 28 (12.7) Choledochal Cyst 1 (1.0) AOR(95%CI) P-value 0.3 (0.2-0.6) <0.0001 1.4 (1.1-1.8) 0.003 4.1 (1.2-16.4) 0.03 4.8 (1.8-15.2) 0.0010 6.3 (2.8-15.8) 7.9 (4.9-13.4) 14.2 (7.9-27.5) HCV, gallstones, cirrhosis, and smoking were independently associated with increased pCCA risk in non-PSC subjects. Gallstones and smoking were independent risk factors for dCCA in non-PSC subjects. There was a significant association between IBD-UC and IBD-CD and pCCA. There was a significant association between IBD and dCCA. In summary, IBD was found to be an independent risk factor for ECC in non-PSC subjects. Variables Objectives Determine whether IBD is an independent risk factor for ECC Identify other risk factors for ECC in non-PSC population Methods References Adjusted Odds Ratio (AOR) Broome, U., R. Lofberg, et al. (1995). "Primary sclerosing cholangitis and ulcerative colitis: evidence for increased neoplastic potential." Hepatology 22(5): 1404-1408. Schrumpf, E., O. Fausa, et al. (1988). "Hepatobiliary complications of inflammatory bowel disease." Seminars in liver disease 8(3): 201-209. Multivariate Analysis of Potential Risk Factors for dCCA Variables AOR(95%CI) P-value 2.2 (1.3-3.6) 0.001 5.4 (1.8-18.3) 0.003 23.5 (4.3-440.3) <0.0001 Acknowledgments Adjusted Odds Ratio (AOR) © 2014 Mayo Foundation for Medical Education and Research