Survival with carcinoma arising in mucosal ulcerative colitis.

Adenocarcinoma of the colon is a well-recognized complication of total chronic ulcerative colitis. The incidence increases with time, and the carcinoma arising in chronic ulcerative colitis has developed a bad clinical reputation in terms of aggressive behavior. The survival statistics of patients with cancer arising in chronic ulcerative colitis are compared with statistics for a group of noncolitic patients with equivalent clinicopathologic staging treated at the same institution. When grouped by extended Duke's classification and compared with carcinoma arising without ulcerative colitis, there was no statistical difference in survival rates. The overall results are worse because of a higher percentage of patients with incurable disease at the time of operation. With improved surveillance and methods of detecting premalignant changes, the necessity for prophylactic proctocolectomy should decline.