Survival following salvage abdominoperineal resection for persistent and recurrent squamous cell carcinoma of the anus: do these disease categories affect survival?
| Autor: | Lester Rosen, S Chadi, Eran N. Choman, Mariana Berho, Saverio Coiro, Natalia Parisi Severino, Steven D. Wexner |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Databases Factual Salvage therapy Perineum Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Abdomen medicine Humans Prospective Studies Treatment Failure Stage (cooking) Prospective cohort study Digestive System Surgical Procedures Aged Neoplasm Staging Salvage Therapy business.industry Abdominoperineal resection Gastroenterology Chemoradiotherapy Middle Aged Anal canal Anus Neoplasms Anus Combined Modality Therapy Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female 030211 gastroenterology & hepatology Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Colorectal Disease. 18:959-966 |
| ISSN: | 1462-8910 |
| DOI: | 10.1111/codi.13288 |
| Popis: | Aim This study aimed to investigate the results of salvage abdominoperineal resection (APR) in patients with persistent or recurrent squamous cell carcinoma of the anus (SCCA). Method Patients with anal neoplasia were identified from a prospective database. Patients with invasive SCCA with demonstrated failure of chemoradiation therapy (CRT) who underwent salvage APR for one of three disease categories (persistent: 24 months) were included. The primary outcome was overall survival after salvage APR. Tumour size, metastatic lymph nodes (LN), circumferential-resection margin positivity (CRM), and neurolymphovascular invasion (NLVI) were correlated with the outcome. Results Thirty-six patients with a median 3-year overall survival of 46% (median follow-up: 24 months) underwent salvage APR due to persistent or recurrent SCCA (14 male, mean age 59 years). Eleven (31%) patients were diagnosed with persistent disease, 17 (47%) with early and 8 (22%) with late recurrence. Two-year overall survival of stage 0/I/II and III/IV disease was 81.5% and 33.74% (p=0.022). Overall disease stage was associated with disease categorization (p=0.009): patients with persistent disease or early recurrence had a significantly higher disease stage than patients with late recurrence (OR = 20.9 and 17.2). Despite apparently improved survival in patients with late disease recurrence on live table analysis, no significant difference was identified in overall survival when stratified by disease category on log-rank test analysis. Conclusion Persistent and recurrent disease does not show any significant difference in survival, but patients with late recurrence may have a better prognosis. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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