Extensive Disease Subtypes in Adult Patients with Ulcerative Colitis: Non-pancolitis Versus Pancolitis
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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.
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.
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).
In patients with extensive UC (E3), pancolitis was associated with higher probabilities of cumulative relapse or admission, indicating poor prognosis.
KeywordsUlcerative colitis Disease extension Prognosis Classification
Funding was provided by Ministry of Health and Welfare (Grant No. HI14C1324) and Ministry of Science, ICT and Future Planning (Grant No. NRF-2017R1A2B4001848).
Dong Suk Shin was involved in acquisition of data, analysis and interpretation of data, and drafting of the manuscript. Yong Eun Park, Yehyun Park, Soo Jung Park, Tae Il Kim, and Won Ho Kim were responsible for the study concept and design and for critical revision of the manuscript for important intellectual content. Jae Hee Cheon was involved in acquisition of data, study concept and design, and critical revision of the manuscript for important intellectual content. All authors approved the final version of the article, including the authorship list.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.