{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:35:47Z","timestamp":1771047347988,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ECCO-Pfizer Research Award 2019"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to evaluate the impact of advanced medical therapies (biologicals and small molecules) on time to colectomy and oncological outcomes in ulcerative colitis (UC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cohort study included UC patients who underwent colectomy between 2003 and 2022 at 2 referral centers in Belgium and the Netherlands. Exposure was the use of advanced medical therapies. Primary outcomes were time to colectomy and colorectal cancer (CRC) rate, compared between 4 periods: P1 (2003-2007), P2 (2008-2012), P3 (2013-2017), and P4 (2018-2022). Secondary outcomes were oncological outcomes, including incidental cancers found unexpectedly in resection specimens or during endoscopic follow-up for medication switch.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 716 patients, the usage of advanced therapies increased from 36.8% in P1 to 89.7% in P4 (P\u2005&amp;lt;\u2005.0001). Median time to colectomy remained comparable (P1: 7.1 years [interquartile ranges (IQR), 2.8-12.9] vs P4: 7.2 years [IQR, 2.7-14.6]; P\u2005=\u2005not significant). Colectomy and colorectal cancer was diagnosed in 72 (10.1%) patients, with no significant change over time (P\u2005=\u2005.44). Proportion of CRC was lower in patients treated with advanced therapies (4.7% vs 23.6%, P\u2005&amp;lt;\u2005.0001) and related to a shorter follow-up (median 6.1 vs 10.3 years, P\u2005&amp;lt;\u2005.0001). Advanced therapy patients had higher incidental cancer rates (37.5% vs 8.3%, P\u2005=\u2005.002), which was associated with reduced CRC-related survival (HR for CRC-related death: 3.3, 95% CI 1.17-9.4; P\u2005=\u2005.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Despite increased usage of advanced medical therapies, time to resection and CRC rates have remained unchanged in UC patients undergoing colectomy over the past 2 decades. Advanced therapy patients had higher incidental cancers rates, associated with decreased CRC survival. Awareness of timely colectomy is crucial for this group.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf015","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T17:05:21Z","timestamp":1737651921000},"source":"Crossref","is-referenced-by-count":3,"title":["The impact of advanced medical therapies on time to resection and colorectal cancer outcomes in ulcerative colitis patients undergoing colectomy"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1432-9606","authenticated-orcid":false,"given":"Eva","family":"Visser","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , location VUMC, Amsterdam ,","place":["The Netherland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Luberto","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven , Leuven 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