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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Surgical outcomes of Korean ulcerative colitis patients with and without colitis-associated cancer
Yong Sik Yoon, Yong Beom Cho, Kyu Joo Park, Seung Hyuk Baik, Sang Nam Yoon, Seung-Bum Ryoo, Kil Yeon Lee, Hungdai Kim, Ryung-Ah Lee, Chang Sik Yu; IBD Study Group, Korean Society of Coloproctology
Yong Sik Yoon, Chang Sik Yu, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul 138-736, South Korea
Yong Beom Cho, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Kyu Joo Park, Seung-Bum Ryoo, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea
Seung Hyuk Baik, Department of Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul 135-720, South Korea
Sang Nam Yoon, Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 150-950, South Korea
Kil Yeon Lee, Department of Surgery, Kyung Hee University School of Medicine, Seoul 130-872, South Korea
Hungdai Kim, Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea
Ryung-Ah Lee, Department of Surgery, Ewha Womans University School of Medicine, Seoul 158-710, South Korea
Author contributions: Yu CS, Park KJ and Yoon YS designed the research; Cho YB, Park KJ, Baik SH, Yoon SN, Ryoo SB, Lee KY, Kim H and Lee RA contributed to data collection; and Yoon YS and Yu CS analyzed the data and wrote the paper.
Ethics approval: The study was reviewed and approved by the Institutional Review Board of Asan Medical Center (IRB No. 2013-0683).
Informed consent: Because this was a retrospective study with minimal risk to patients, it was exempted from obtaining informed consent by the IRB.
Conflict-of-interest: No conflict.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chang Sik Yu, MD, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
csyu@amc.seoul.kr
Telephone: +82-230-103494 Fax: +82-230-106701
Received: October 29, 2014
Peer-review started: October 29, 2014
First decision: November 26, 2014
Revised: December 17, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: March 28, 2015
Processing time: 152 Days and 1.4 Hours
AIM: To determine the clinicopathologic characteristics of surgically treated ulcerative colitis (UC) patients, and to compare the characteristics of UC patients with colitis-associated cancer (CAC) to those without CAC.
METHODS: Clinical data on UC patients who underwent abdominal surgery from 1980 to 2013 were collected from 11 medical institutions. Data were analyzed to compare the clinical features of patients with CAC and those of patients without CAC.
RESULTS: Among 415 UC patients, 383 (92.2%) underwent total proctocolectomy, and of these, 342 (89%) were subjected to ileal pouch-anal anastomosis. CAC was found in 47 patients (11.3%). Adenocarcinoma was found in 45 patients, and the others had either neuroendocrine carcinoma or lymphoma. Comparing the UC patients with and without CAC, the UC patients with CAC were characteristically older at the time of diagnosis, had longer disease duration, underwent frequent laparoscopic surgery, and were infrequently given preoperative steroid therapy (P < 0.001-0.035). During the 37 mo mean follow-up period, the 3-year overall survival rate was 82.2%.
CONCLUSION: Most Korean UC patients experience early disease exacerbation or complications. Approximately 10% of UC patients had CAC, and UC patients with CAC had a later diagnosis, a longer disease duration, and less steroid treatment than UC patients without CAC.
Core tip: This multi-center study is the first nationwide report on the surgical outcomes of Korean ulcerative colitis (UC) patients and reflects the recent status of surgically treated Korean UC patients. The authors found that most Korean UC patients experienced early disease exacerbation or complications. Approximately 10% of UC patients had colitis-associated cancer (CAC), and UC patients with CAC had a later diagnosis, a longer disease duration, and less steroid treatment than UC patients without CAC.
