Extensive Disease Subtypes in Adult Patients with Ulcerative Colitis: Non-pancolitis Versus Pancolitis

• Published in: Digestive diseases and sciences Vol. 63; no. 11; pp. 3097 - 3104
• Main Authors: Shin, Dong Suk, Cheon, Jae Hee, Park, Yong Eun, Park, Yehyun, Park, Soo Jung, Kim, Tae Il, Kim, Won Ho
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-11-2018; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Adults; Aged; Aged, 80 and over; Analysis; Biochemistry; Colectomy - statistics & numerical data; Colitis, Ulcerative - classification; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - surgery; Colon; Comorbidity; Corticosteroids; Development and progression; Female; Gastroenterology; Hepatology; Hospitalization - statistics & numerical data; Humans; Immunologic Factors - therapeutic use; Inflammatory bowel disease; Male; Medical prognosis; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Oncology; Original Article; Recurrence; Retrospective Studies; Transplant Surgery; Tumor necrosis factor-TNF; Ulcerative colitis; Young Adult; Prognosis; Disease extension; Classification; Ulcerative colitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-018-5218-x

Background and Aim
Few studies have compared pancolitis and non-pancolitis E3 in adult patients with ulcerative colitis (UC). This study aimed to evaluate the natural disease courses and factors affecting outcomes between pancolitis and non-pancolitis E3.
Methods
We retrospectively analyzed 117 patients, including 93 with extensive colitis (E3) and 24 with UC confined to the rectum or left-sided colon and appendiceal orifice inflammation at the time of diagnosis, who were regularly followed up for at least 1 year. Patients with E3 were divided into two groups according to the degree of disease extension: pancolitis group (disease extent up to the cecum or proximal ascending colon) and non-pancolitis E3 group (disease extent above the splenic flexure but not up to the proximal ascending colon). Clinical findings at diagnosis; comorbidity; medications; Mayo score; cumulative rates of corticosteroid, immunomodulator, and anti-tumor necrosis factor (anti-TNF) alpha use; relapse; and admission were compared between the pancolitis and non-pancolitis E3 groups.
Results
The median follow-up duration of the 117 patients was 74 (range 15–158) months. Fifty-one patients (43.5%) had pancolitis. The Mayo score at initial diagnosis, cumulative relapse rate, and cumulative admission rate were significantly higher in the pancolitis group than in the non-pancolitis E3 group (
P
 < 0.001,
P
 = 0.023 and
P
 = 0.007, respectively). However, there was no significant difference between the groups in the rates of cumulative immunomodulator and anti-TNF alpha use (
P
 = 0.67 and
P
 = 0.73, respectively).
Conclusions
In patients with extensive UC (E3), pancolitis was associated with higher probabilities of cumulative relapse or admission, indicating poor prognosis.