@article{51b1071e2f6348439a768eb4f02d162c,
title = "A nationwide database study on colectomy and colorectal cancer in ulcerative colitis: what is the role of appendectomy?",
abstract = "Aim: Although has been suggested that an appendectomy has a positive effect on the disease course in patients with ulcerative colitis (UC), recent studies indicate a potential increase in risk of colectomy and colorectal cancer (CRC). This study aimed to evaluate the rates of colectomy and CRC after appendectomy in UC patients using a nationwide prospective database [the Initiative on Crohn and Colitis Parelsnoer Institute – Inflammatory Bowel Disease (ICC PSI-IBD) database]. Method: All UC patients were retrieved from the ICC PSI-IBD database between January 2007 and May 2018. Primary outcomes were colectomy and CRC. Outcomes were compared in patients with and without appendectomy, with a separate analysis for timing of appendectomy (before or after UC diagnosis). Results: A total of 826 UC patients (54.7% female; median age 46 years, range 18–89 years) were included. Sixty-three (7.6%) patients had previously undergone appendectomy: 24 (38.1%) before and 33 (52.4%) after their diagnosis of UC. In multivariate analysis, appendectomy after UC diagnosis was associated with a significantly lower colectomy rate compared with no appendectomy [hazard ratio (HR) 0.16, 95% C: 0.04–0.66, P = 0.011], and the same nonsignificant trend was seen in patients with an appendectomy before UC diagnosis (HR 0.35, 95% CI 0.08–1.41, P = 0.138). Appendectomy was associated with delayed colectomy, particularly when it was performed after diagnosis of UC (P = 0.009). No significant differences were found in the CRC rate between patients with and without appendectomy (1.6% vs 1.2%; P = 0.555). Conclusion: Appendectomy in established UC is associated with an 84% decreased risk of colectomy and a delay in surgery. Since the colon is in situ for longer, the risk of developing CRC remains, which underscores the importance of endoscopic surveillance programmes.",
keywords = "Appendectomy, colectomy, colorectal cancer, ulcerative colitis",
author = "Stellingwerf, {M. E.} and Bemelman, {W. A.} and M. L{\"o}wenberg and Ponsioen, {C. Y.} and D'Haens, {G. R.} and {van Dieren}, S. and Buskens, {C. J.}",
note = "Funding Information: MES, WAB, SvD, CJB, GD, BO, MJP and CJvdW have no conflicts of interest to declare. ML has served as speaker and/or principal investigator for: AbbVie, Celgene, Covidien, Dr. Falk Pharma, Ferring Pharmaceuticals, Gilead, GlaxoSmithKline, Janssen‐Cilag, Merck Sharp & Dohme, Pfizer, Protagonist Therapeutics, Receptos, Takeda, Tillotts, Tramedico. He has received research grants from AbbVie, Merck Sharp & Dohme, Dr Falk, Achmea Healthcare and ZonMW. CYP has served as speaker for Takeda, Tillotts and AbbVie, received research grants from Takeda, and acted as consultant for Takeda and Pliant. GRD{\textquoteright}H has served as advisor for AbbVie, Ablynx, Allergan, Amakem, Amgen, AM Pharma, Arena Pharmaceuticals, AstraZeneca, Avaxia, Biogen, Bristol Myers Squibb, Boerhinger Ingelheim, Celgene/Receptos, Celltrion, Cosmo, Covidien/Medtronics, Echo Pharmaceuticals, Eli Lilly, Engene, Ferring, Dr Falk Pharma, Galapagos, Genentech/Roche, Gilead, GlaxoSmithKline, Gossamerbio, Hospira/Pfizer, Immunic, Johnson and Johnson, Lycera, Medimetrics, Millenium/Takeda, Mitsubishi Pharma, Merck Sharp & Dohme, Mundipharma, Nextbiotics, Novonordisk, Otsuka, Pfizer/Hospira, Photopill, Prometheus Laboratories/Nestle, Progenity, Protagonist, Robarts Clinical Trials, Salix, Samsung Bioepis, Sandoz, Seres/Nestle, Setpoint, Shire, Teva, Tigenix, Tillotts, Topivert, Versant and Vifor; received speaker fees from AbbVie, Biogen, Ferring, Johnson and Johnson, Merck Sharp & Dohme, Mundipharma, Norgine, Pfizer, Samsung Bioepis, Shire, Millenium/Takeda, Tillotts and Vifor. Funding Information: The Parelsnoer Institute is part of and funded by the Dutch Federation of University Medical Centres and has received initial funding from the Dutch Government (from 2007 to 2011). The authors thank the Parelsnoer Institute for providing the data, and Florien Toxopeus, Marjolein de Koning, Jitteke de Jong and Vince Biemans for verifying the accuracy of data on appendectomies performed in the same month as colectomy. Contributors: N. K. de Boer, MD PhD, (Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam), G. Dijkstra, MD PhD (University Medical Centre, University of Groningen), F. Hoentjen, MD PhD, (Radboud University Medical Centre, Nijmegen), A. E. van der Meulen-de Jong, MD PhD, (University Medical Centre, Leiden), B. Oldenburg, MD PhD (University Medical Centre,?Utrecht), M. J. Pierik, MD PhD, (University Medical Centre, Maastricht), C. J. van der Woude, MD PhD (Erasmus University Medical Centre, Rotterdam). Funding Information: The Parelsnoer Institute is part of and funded by the Dutch Federation of University Medical Centres and has received initial funding from the Dutch Government (from 2007 to 2011). Publisher Copyright: Colorectal Disease {\textcopyright} 2020 The Association of Coloproctology of Great Britain and Ireland Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jan,
doi = "https://doi.org/10.1111/codi.15184",
language = "English",
volume = "23",
pages = "64--73",
journal = "Colorectal disease",
issn = "1462-8910",
publisher = "Wiley-Blackwell",
number = "1",
}