PROGNOSIS OF PANCOLITIS IN ULCERATIVE-COL ITIS

Objective. - To assess the prognosis of pancolitis in ulcerative colit is including survival, colectomy rate, colon cancer risk, activity of disease, functional and socio-professional impact. Methods. - Retrospe ctive study of 130 cases of ulcerative pancolitis referred consecutive ly to Rothschild Hospital from 1962 to 1993. They were 58 men and 72 w omen. The mean age at onset of ulcerative colitis was 30 years (range: 5-77). The extension to the right colon was secondary in 68 % of pati ents. The period of observation ranged from 0.8 year to 46 years from the onset, with a median of 10.6 years. Three patients were lost to fo llow up. Results. - Eight patients died, the survival rate being 93 % at 10 years. Surgical treatment was performed in 85 patients. The cumu lative colectomy rates were 61 % and 77 % at 10 and 20 years respectiv ely. Colonic cancer developed in three patients, corresponding to a cu mulative risk after 25 years of 6 % in unoperated patients and 1.9 % i n the whole series. No cancer occurred after colectomy and ileorectal anastomosis. In the group of unoperated patients there was a decrease of activity of the disease during the first fifteen years. The quality of life of colectomized patients with reestablishment of intestinal c ontinuity and of those treated conservatively did not differ significa ntly. Conclusion. - In this series, long term prognosis of ulcerative pancolitis was favourable. The high colectomy rare was balanced by a v ery low risk of colorectal cancer.