Risk factors and outcome following salvage surgery for squamous cell carcinoma of the anus.

Relapse Salvage surgery Squamous cell carcinoma of the anus Survival

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 20 04 2023
revised: 08 07 2023
accepted: 28 08 2023
pubmed: 2 9 2023
medline: 2 9 2023
entrez: 1 9 2023
Statut: ppublish

Résumé

Chemoradiotherapy is the primary treatment for anal cancer. 15-33% of patients will have persistent or recurrent disease after treatment requiring salvage surgery. Relapse after surgery, postoperative complications, and mortality as well as possible risk factors are not fully understood due to the rareness of the disease. The aim of the study was to report outcomes after salvage surgery as well as evaluate risk factors for postoperative complications, cancer relapse and survival. Data were retrospectively collected from electronical patients charts and pathology reports from all patients undergoing salvage surgery from July 1st A total of 98 patients were included in the study. The 5-year overall survival was 61.8%. Relapse after surgery occurred in 36.7% of patients and was significantly associated with R1-resection (HR = 4.4) and preoperative nodal metastases (HR = 4.5). Negative prognostic factors for survival were found to be R1-resection (HR = 3.2), preoperative nodal metastases (HR = 2.9), and male gender (HR = 0.5). There was no association found between complications and survival (HR 1.2). None of the possible risk factors were associated with major postoperative complications. An acceptable overall survival after surgery was found. Survival and relapse-free survival was negatively associated with R1 resections and positive preoperative lymph nodes. Complications did not influence long-term survival.

Sections du résumé

BACKGROUND BACKGROUND
Chemoradiotherapy is the primary treatment for anal cancer. 15-33% of patients will have persistent or recurrent disease after treatment requiring salvage surgery. Relapse after surgery, postoperative complications, and mortality as well as possible risk factors are not fully understood due to the rareness of the disease. The aim of the study was to report outcomes after salvage surgery as well as evaluate risk factors for postoperative complications, cancer relapse and survival.
METHODS METHODS
Data were retrospectively collected from electronical patients charts and pathology reports from all patients undergoing salvage surgery from July 1st
RESULTS RESULTS
A total of 98 patients were included in the study. The 5-year overall survival was 61.8%. Relapse after surgery occurred in 36.7% of patients and was significantly associated with R1-resection (HR = 4.4) and preoperative nodal metastases (HR = 4.5). Negative prognostic factors for survival were found to be R1-resection (HR = 3.2), preoperative nodal metastases (HR = 2.9), and male gender (HR = 0.5). There was no association found between complications and survival (HR 1.2). None of the possible risk factors were associated with major postoperative complications.
CONCLUSIONS CONCLUSIONS
An acceptable overall survival after surgery was found. Survival and relapse-free survival was negatively associated with R1 resections and positive preoperative lymph nodes. Complications did not influence long-term survival.

Identifiants

pubmed: 37657174
pii: S0748-7983(23)00688-1
doi: 10.1016/j.ejso.2023.107050
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107050

Informations de copyright

© 2023 Published by Elsevier Ltd.

Auteurs

Julie Borg (J)

Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. Electronic address: juborg@rm.dk.

Karen-Lise Garm Spindler (KL)

Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. Electronic address: K.G.Spindler@rm.dk.

Birgitte Mayland Havelund (BM)

Department of Oncology, University Hospital of Southern Denmark, Lillebaelt Hospital, Beriderbakken 4, 7100, Vejle, Denmark. Electronic address: Birgitte.Mayland.Havelund@rsyd.dk.

Mette Møller Sørensen (MM)

Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. Electronic address: metsoren@rm.dk.

Jonas Amstrup Funder (JA)

Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. Electronic address: jonafund@rm.dk.

Classifications MeSH