BACKGROUND: Chemoradiation is first-line therapy for epidermoid carcinoma of the anus (ECA). Surgery is reserved for treatment failures. The authors report outcomes after salvage procedures for ECA. METHODS: All treatment failures managed with radical surgery between 1998 and 2006 in our institution were reviewed. The Kaplan-Meier method was used for survival analysis. Log-rank and Cox regression were used for univariate and multivariate analysis, respectively. RESULTS: Fifty-one patients underwent salvage abdominoperineal resection for locoregional failure. Five-year overall survival after abdominoperineal resection was 29% (median, 22 months). Age, gender, human immunodeficiency virus status, tumor-node-metastasis stage, node status, and failure type did not predict survival. Negative resection margin was most strongly associated with improved overall and disease-free survival (P = .03 and P < .0001, respectively). Median survival for patients undergoing inguinal lymph node dissection for regional recurrence (n = 6) was 11 months, with freedom from cancer achieved in 2 of 6 patients. CONCLUSIONS: Recurrent anal carcinoma after primary chemoradiotherapy carries a poor prognosis. Salvage abdominoperineal resection offers a potential for long-term survival.
BACKGROUND: Chemoradiation is first-line therapy for epidermoid carcinoma of the anus (ECA). Surgery is reserved for treatment failures. The authors report outcomes after salvage procedures for ECA. METHODS: All treatment failures managed with radical surgery between 1998 and 2006 in our institution were reviewed. The Kaplan-Meier method was used for survival analysis. Log-rank and Cox regression were used for univariate and multivariate analysis, respectively. RESULTS: Fifty-one patients underwent salvage abdominoperineal resection for locoregional failure. Five-year overall survival after abdominoperineal resection was 29% (median, 22 months). Age, gender, human immunodeficiency virus status, tumor-node-metastasis stage, node status, and failure type did not predict survival. Negative resection margin was most strongly associated with improved overall and disease-free survival (P = .03 and P < .0001, respectively). Median survival for patients undergoing inguinal lymph node dissection for regional recurrence (n = 6) was 11 months, with freedom from cancer achieved in 2 of 6 patients. CONCLUSIONS: Recurrent anal carcinoma after primary chemoradiotherapy carries a poor prognosis. Salvage abdominoperineal resection offers a potential for long-term survival.
Authors: Shouki N Bazarbashi; Ali M Alzahrani; Mohammed M Rahal; Ahmed S Al-Shehri; Ali H Aljubran; Nasser A Alsanea; Omar A Al-Obeed; Magdy S Kandil; Jamal E Zekri; Ashwaq A Al Olayan; Abdullah A Alsharm; Khaled S Balaraj Journal: Saudi Med J Date: 2014-12 Impact factor: 1.484
Authors: Paulo C Soares; Eliana S Abdelhay; Luiz Claudio S Thuler; Bruno Moreira Soares; Samia Demachki; Gessica Valéria Rocha Ferro; Paulo P Assumpção; Leticia Martins Lamarão; Luis Felipe Ribeiro Pinto; Rommel Mario Rodríguez Burbano Journal: BMC Gastroenterol Date: 2018-02-21 Impact factor: 3.067
Authors: Rohit Kochhar; Andrew G Renehan; Damian Mullan; Bipasha Chakrabarty; Mark P Saunders; Bernadette M Carrington Journal: Eur Radiol Date: 2016-04-18 Impact factor: 5.315
Authors: J A W Hagemans; S E Blinde; J J Nuyttens; W G Morshuis; M A M Mureau; J Rothbarth; C Verhoef; J W A Burger Journal: Ann Surg Oncol Date: 2018-04-24 Impact factor: 5.344