Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Jan 21, 2027; 33(3): 123418
Published online Jan 21, 2027. doi: 10.3748/wjg.123418
Published online Jan 21, 2027. doi: 10.3748/wjg.123418
Long-term treatment trajectories and surgical outcomes in Chinese patients with ulcerative colitis
Wen-Jing Yang, Ling-Ya Yao, Yu-Shu Cao, Wen-Hao Xia, Xiang-Han Cao, Yi-Ning Xu, You-Jie Miao, Qian Cao, Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Author contributions: Yang WJ, Yao LY, and Cao Q contributed to the study concept and design; Yang WJ, Cao YS, Xia WH, Cao XH, Xu YN, and Miao YJ contributed to data acquisition; Yang WJ contributed to formal analysis, visualization, and manuscript drafting; Yang WJ, Yao LY, Cao YS, and Cao Q contributed to manuscript revision; and all the authors contributed to data interpretation and approved the final version of the manuscript for submission.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Supported by National Key Research and Development Program of China, No. 2023YFC2507300; National Natural Science Foundation of China, No. 82341215 and No. 82370531; and Key-Area Research and Development Program of Guangdong Province, No. 2023B1111040003.
Institutional review board statement: This study was approved by the Ethics Committee of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (Approval No. 2025-1291).
Informed consent statement: The requirement for informed patient consent was waived given the retrospective, non-interventional study design.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Corresponding author: Qian Cao, MD, PhD, Professor, Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. caoq@zju.edu.cn
Received: May 18, 2026
Revised: June 13, 2026
Accepted: July 16, 2026
Published online: January 21, 2027
Processing time: 182 Days and 6.9 Hours
Revised: June 13, 2026
Accepted: July 16, 2026
Published online: January 21, 2027
Processing time: 182 Days and 6.9 Hours
Core Tip
Core Tip: In this large real-world cohort of 1882 Chinese patients with ulcerative colitis followed for a median of 6.22 years, baseline disease activity was a major determinant of treatment escalation and colectomy risk. Although most patients with mild-to-moderate disease achieved sustained control with 5-aminosalicylate, important gaps in treat-to-target care remained, including infrequent early endoscopic reassessment and delayed treatment optimization among nonresponders. These fin