Impact of previous diverticulitis on 5-year survival and recurrence rates in patients with colorectal cancer

Figures & data

Figure 1. Flow chart of the study cohort. CRC: Colorectal Cancer; TEM: Transanal Endoscopic Microsurgery; IBD: Inflammatory Bowel Disease; UC: Ulcerative Colitis; CD: Crohn’s Disease.

Table 1. Clinical characteristics of the study cohort.

Variables	Sporadic CRC (n = 984)	Diverticulitis (n = 28)	IBD (n = 26)	Hereditary (n = 14)	p  Value
Age (years)	64.5 (64.0–65.1) ^I, H	62.8 (59.6–66.2) ^H	57.3 (53.9–60.8) ^S, H	47.3 (42.6–52.0) ^S, D, I	<0.001
Age ≤ 50	67 (6.8) ^I, H	4 (14.3) ^H	7 (26.9) ^S	8 (57.1) ^S, D	<0.001
Gender
Female	432 (43.9)	12 (42.9)	13 (50)	6 (42.9)	0.939
Male	552 (56.1)	16 (57.1)	13 (50)	8 (57.1)
BMI (kg/m^2) Missing (n = 14)	26.2 (25.9–26–5)	26.4 (24.7–28.1)	26.7 (24.5–28.9)	25.6 (23.6–27.7)	0.937
ASA-Class Missing (n = 8)
1	171 (17.5)	3 (11.1)	1 (3.8)	6 (42.9)	0.117
2	529 (54.1)	17 (63.0)	18 (69.2)	7 (50.0)
3	265 (27.1)	6 (22.2)	7 (26.9)	1 (7.1)
4	12 (1.2)	1 (3.7)	0 (0.0)	0 (0.0)
Diverticulitis location
Sigmoid colon	–	26 (92.9)	–	–	–
Ascending colon	–	2 (7.1)	–	–	–
Tumour location
Colon	557 (56.6) ^D, H	26 (92.9) ^S	21 (80.8)	14 (100) ^S	<0.001
Rectum	427 (43.4) ^D, H	2 (7.1) ^S	5 (19.2)	0 (0.0) ^S
Neoadjuvant therapy Missing (n = 2)
Radiation	294 (29.9)	2 (7.1)	4 (15.4)	0 (0.0)	0.002
Chemo	147 (15.0)	3 (10.7)	5 (19.2)	1 (7.1)	0.696
Surgery
Acute	94 (9.6) ^D	10 (35.7) ^S	3 (11.5)	1 (7.1)	<0.001
Elective	890 (90.4) ^D	18 (64.3) ^S	23 (88.5)	13 (92.9)
Differential grade Missing (n = 178)
High	681 (83.7) ^I, H	22 (88.0)	13 (56.5) ^S	6 (50.0) ^S	<0.001
Low	133 (16.3) ^I, H	3 (12.0)	10 (43.5) ^S	6 (50.0) ^S
pT-stage Missing (n = 15)
0	13 (1.3)	0 (0.0)	1 (4.0)	0 (0.0)	0.477
1	72 (7.4)	2 (7.1)	1 (4.0)	2 (15.4)
2	170 (17.5)	2 (7.1)	2 (8.0)	1 (7.7)
3	499 (51.4)	15 (53.6)	11 (44.0)	7 (53.8)
4	217 (22.3)	9 (32.1)	10 (40.0)	3 (23.1)
pN-stage Missing (n = 11)
0	531 (54.5)	13 (46.4)	10 (40.0)	7 (53.8)	0.489
1	286 (29.3)	9 (32.1)	11 (44.0)	5 (38.5)
2	153 (15.7)	6 (21.4)	4.0 (16.0)	1.0 (7.7)
X	5.0 (0.5)	0 (0.0)	0 (0.0)	0 (0.0)
Adjuvant therapy Missing (n = 163)	398 (47.6)	13 (61.9)	15 (71.4)	5 (45.5)	0.101

BMI: Body mass index; ASA-Class: American Society of Anaesthesiologists; CRC: Colorectal cancer; IBD: Inflammatory bowel disease.

Multiple comparison of significance between the groups are shown as (x)^S/I/D/H. (x)^S/I/D/H = A significant difference from at least one other group. (S: Sporadic CRC; D: Diverticulitis; I: IBD; H: Hereditary). Significant P-values are presentet in bold.

Figure 2. Bar chart over duration from diverticulitis diagnosis to CRC-operation.

Figure 3. Outcome curves comparing 5-year survival and recurrence free patients between the 4 subgroups of CRC. IBD: Inflammatory bowel disease.

Figure 4. 5-year survival and recurrence free patients for the groups ACD and AUD compared to Sporadic cases of CRC. ACD: Acute Complicated Diverticulitis; AUD: Acute Uncomplicated Diverticulitis.

Table 2. Five-year oncological outcomes compared between the four subgroups.

Variables		Sporadic CRC (n = 984)	Diverticulitis (n = 28)	IBD (n = 26)	Hereditary (n = 14)	p Value
Mortality Cum-proportion surviving	Total	123 (12.5)	7 (25.0)	4 (15.4)	1 (7.1)	0.23
		0.85 (0.83–0.87)	0.75 (0.59–0.91)	0.85 (0.71–0.99)	0.93 (0.79–1.07)	0.15
Recurrence Cum-proportion recurrence free	Total	185 (18.8)	8 (28.6)	6 (23.1)	2 (14.3)	0.54
		0.81 (0.79–0.83)	0.71 (0.53–0.89)	0.77 (0.61–0.93)	0.86 (0.68–1.0)	0.49
	Local	46 (24.9)	3 (37.5)	1 (16.7)	0.0 (0.0)	0.39
		0.95 (0.93–0.97)	0.88 (0.76–1)	0.95 (0.85–1.05)	1.0 (1.0–1.0)	0.37
	Distant	129 (69.7)	5 (62.5)	4 (66.7)	2 (100)	0.89
		0.86 (0.84–0.88)	0.81 (0.65–0.97)	0.84 (0.7–0.98)	0.86 (0.86–1.04)	0.84
	Both	10 (5.4)	0 (0.0)	1 (16.7)	0 (0.0)	0.49
		0.99 (0.99–0.99)	1.0 (1.0–1.0)	0.96 (0.88–1.04)	1.0 (1.0–1.0)	0.46

S: Sporadic CRC; D: Diverticulitis; I: IBD; H: Hereditary. P-value for Log Rank method is presented in the far right coloumn.

Table 3. Five-year oncological outcomes in patients with ACD, AUD and sporadic CRC.

Variables	Sporadic CRC (n = 984)	ACD (n = 18)	AUD (n = 10)	p Value
Mortality Cum-proportion surviving	123 (12.5)	7 (38.9)	0 (0.0)	0.002
	0.85 (0.83–0.87)	0.61 (0.39–0.82)	1 (1.0–1.0)	<0.001
Recurrence Cum-proportion recurrence free	185 (18.8)	7 (38.9)	1 (10.0)	0.076
	0.81 (0.79–0.83)	0.61 (0.39–0.82)	0.9 (0.72–1.1)	0.047

Multiple comparison of significance between the groups are shown as (x)^{ACD, AUD, Sporadic}. (x)^{ACD, AUD, Sporadic}= A significant difference from at least one other group. (S: Sporadic; ACD: Acute complicated diverticulitis; AUD: Acute uncomplicated diverticulitis). P-value for Log Rank method is presented in the far right coloumn. Significant P-values are presentet in bold.