Dataset Information

Increased Proportion of Colorectal Cancer in Patients with Ulcerative Colitis undergoing Surgery in the Netherlands.

ABSTRACT:

Introduction

The aim of the current study was to assess if there is an indication shift for surgery in patients with UC from refractory disease to malignant degeneration over the last 3 decades.

Methods

All patients with histologically confirmed UC who underwent a colorectal resection between 1991 and 2020 were extracted from the nationwide Dutch Pathology Registry (PALGA). The primary outcome was the proportion of CRC in the colon specimens. Outcomes were compared between 3 periods (P1: 1991-2000, P2: 2001-2010, P3: 2011-2020).

Results

Overall, 6,094 UC patients were included of which 4,854 underwent a (procto)colectomy and 1,240 a segmental resection. In 1,031 (16.9%) patients, CRC was demonstrated in the pathological resection specimen after a median disease duration of 11 years [IQR 3.0-19.0]. The proportion of CRC increased from 11.3% in P1, to 16.1% in P2, and 22.8% in P3 (p<0.001). Median disease duration at the time of resection increased from 4 years in P1, to 10 years in P2, and 17 years in P3 (p<0.001). The proportion of patients diagnosed with advanced malignancy (pT3/T4) (P1: 61.2% vs. P2: 65.2% vs. P3: 62.4%, respectively, p=0.633) and lymph node metastasis (N+) (P1: 33.0% vs. P2: 41.9% vs. P3: 38.2%, respectively, p=0.113) did not change over time.

Discussion

This nationwide pathology study demonstrated an increased proportion of surgery for CRC over the last 3 decades. We hypothesize that the expanding therapeutic armamentarium for UC leads to exhausting medical options and hence postponed colectomy. This however, might be at the expense of an increased risk of CRC in the long term.

SUBMITTER: Heuthorst L

PROVIDER: S-EPMC10144357 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Increased Proportion of Colorectal Cancer in Patients With Ulcerative Colitis Undergoing Surgery in the Netherlands.

Heuthorst Lianne L Harbech Houda H Snijder Harmanna J HJ Mookhoek Aart A D'Haens Geert R GR Vermeire Séverine S D'Hoore André A Bemelman Willem A WA Buskens Christianne J CJ

The American journal of gastroenterology 20221223 5

<h4>Introduction</h4>The aim of the current study was to assess whether there is an indication shift for surgery in patients with ulcerative colitis (UC) from refractory disease to malignant degeneration over the past 3 decades.<h4>Methods</h4>All patients with histologically confirmed UC who underwent a colorectal resection between 1991 and 2020 were extracted from the nationwide Dutch Pathology Registry. The primary outcome was the proportion of colorectal cancer (CRC) in the colon specimens. ...[more]

PMID: 36623170

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