Outcome of surgery for recurrent anal cancer: results from a tertiary referral centre

Autor: G. Branagan, Helen Chave, M. Bignell
Rok vydání: 2017
Předmět:
Adult
Graft Rejection
Male
medicine.medical_specialty
Databases
Factual
medicine.medical_treatment
Tertiary referral centre
Kaplan-Meier Estimate
Dehiscence
Risk Assessment
Disease-Free Survival
Statistics
Nonparametric
Surgical Flaps
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Interquartile range
Recurrent Anal Cancer
medicine
Anal cancer
Humans
Neoplasm Invasiveness
Aged
Neoplasm Staging
Retrospective Studies
Aged
80 and over
Salvage Therapy
Proctectomy
business.industry
Incidence (epidemiology)
Anastomosis
Surgical
Gastroenterology
Middle Aged
Plastic Surgery Procedures
medicine.disease
Anus Neoplasms
Prognosis
Surgery
Survival Rate
030220 oncology & carcinogenesis
Liposuction
030211 gastroenterology & hepatology
Female
Neoplasm Recurrence
Local
business
Chemoradiotherapy
Zdroj: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 20(9)
ISSN: 1463-1318
Popis: AIM Chemoradiotherapy remains the first line of treatment for anal cancer with surgery reserved for cancer recurrence or persistence. The low incidence of anal cancer means that the numbers undergoing surgery is small with centralization for excision to regional cancer centres. We present our experience of abdominal perineal excision, with reconstruction of the perineal defect (APERR), within a tertiary centre. METHOD Over a 15-year period, data were collected retrospectively from notes of patients who underwent an APERR. The aim was to look at disease-free and overall survival and complications associated with flap reconstruction. RESULTS In the study period, 29 patients [median age = 62 (range: 42-81; interquartile range: 54-68) years] underwent APERR. Median follow-up was 77 (4-200) months. Thirteen patients died during follow-up; eight from their disease, with a median survival time of 16 (4-63) months. Five-year survival was 67%. Nine (31%) patients had recurrence during the follow up period; this was local (n = 2), regional (n = 4), distant (n = 2) or a combination (n = 1). Sixteen (55%) patients developed 24 complications, including nine (31%) flap complications and 10 (34%) parastomal hernias. Flap complications were flap failure (n = 1) requiring direct closure, flap dehiscence (n = 2), necrosis of flap tip (n = 1), wound infection (n = 4) and a bulky flap (n = 1) requiring liposuction. CONCLUSION APERR of anal cancer is a feasible technique with excellent oncological treatment and acceptable long-term complications, although a higher than expected rate of parastomal hernia was noted.
Databáze: OpenAIRE
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