Long-term overall survival in patients undergoing liver resection for metastatic anal squamous cell carcinoma.
anal cancer
liver surgery
metastatic
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
29 Nov 2023
29 Nov 2023
Historique:
revised:
16
10
2023
received:
14
09
2023
accepted:
18
10
2023
medline:
29
11
2023
pubmed:
29
11
2023
entrez:
29
11
2023
Statut:
aheadofprint
Résumé
There is limited research on management of metastatic anal canal squamous cell carcinoma (SCC) to the liver. This study aimed to describe outcomes for patients undergoing liver resection of anal SCC metastases. A multicenter, retrospective cohort study was conducted by three tertiary-referral centers. Patients undergoing liver surgery between 2008 and 2022 were included. Cox regression analysis was performed to evaluate predictors of recurrence and survival and Kaplan-Meier analysis was performed for 1-, 3-, and 5-year survival. Twenty-one patients underwent liver resection and/or ablation. None were HIV positive and 24% had known HPV infection. 20/21(95%) patients had undergone Nigro protocol for management of the primary tumor with 12/21 (57%) patients experiencing complete response. 4/21 (19%) patients had synchronous liver metastases at time of diagnosis. Median tumor size was 5.0 cm and median tumor number was one. At analysis, 52% remained alive. Median overall survival was 32.2 months. 5-year overall survival was 50%. Median recurrence-free survival was 7.7 months and 5-year recurrence-free survival was 30%. Need for salvage abdominoperineal resection was negatively associated with recurrence-free survival. The most common site of recurrence was the liver. Liver resection for metastatic anal SCC can be beneficial for appropriately selected patients.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
There is limited research on management of metastatic anal canal squamous cell carcinoma (SCC) to the liver. This study aimed to describe outcomes for patients undergoing liver resection of anal SCC metastases.
METHODS
METHODS
A multicenter, retrospective cohort study was conducted by three tertiary-referral centers. Patients undergoing liver surgery between 2008 and 2022 were included. Cox regression analysis was performed to evaluate predictors of recurrence and survival and Kaplan-Meier analysis was performed for 1-, 3-, and 5-year survival.
RESULTS
RESULTS
Twenty-one patients underwent liver resection and/or ablation. None were HIV positive and 24% had known HPV infection. 20/21(95%) patients had undergone Nigro protocol for management of the primary tumor with 12/21 (57%) patients experiencing complete response. 4/21 (19%) patients had synchronous liver metastases at time of diagnosis. Median tumor size was 5.0 cm and median tumor number was one. At analysis, 52% remained alive. Median overall survival was 32.2 months. 5-year overall survival was 50%. Median recurrence-free survival was 7.7 months and 5-year recurrence-free survival was 30%. Need for salvage abdominoperineal resection was negatively associated with recurrence-free survival. The most common site of recurrence was the liver.
CONCLUSIONS
CONCLUSIONS
Liver resection for metastatic anal SCC can be beneficial for appropriately selected patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Victor and Anna Mae Beghini Charitable Foundation
Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Goldner M, Platoff R, Betances A, et al. Role of metastasectomy for liver metastasis in stage IV anal cancer. Am J Surg. 2021;221(4):832-838.
Benson AB, Al-Hawary MM, Azad N, et al. NCCN Guidelines Version 2.2022 Anal Carcinoma Continue NCCN Guidelines Panel Disclosures. NCCN; 2022. https://www.nccn.org/professionals/physician_gls/pdf/anal.pdf
Dumarco RB, Fonseca GM, Coelho FF, et al. Multiple colorectal liver metastases resection can offer long-term survival: the concept of a chronic neoplastic disease. Surgery. 2023;173(4):983-990.
Ng ZQ, Navadgi S, Gunawardena D, Jacob A. Hepatic metastasis of anal squamous cell carcinoma. BMJ Case Rep. 2022;15(1):e247470.
Gnanajothy R, Warren GW, Okun S, Peterson LL. A combined modality therapeutic approach to metastatic anal squamous cell carcinoma with systemic chemotherapy and local therapy to sites of disease: case report and review of literature. J Gastrointest Oncol. 2016;7(3):E58-E63.
Tokar M, Bobilev D, Zalmanov S, Geffen DB, Walfisch S. Combined multimodal approach to the treatment of metastatic anal carcinoma: report of a case and review of the literature. Onkologie. 2006;29(1-2):30-32.
Pawlik TM, Gleisner AL, Bauer TW, et al. Liver-directed surgery for metastatic squamous cell carcinoma to the liver: results of a multi-center analysis. Ann Surg Oncol. 2007;14(10):2807-2816.
Gurfinkel R, Walfisch S. Combined treatment of basaloid anal carcinoma using cisplatin, 5-fluorouracil and resection of hepatic metastasis. Tech Coloproctol. 2005;9(3):235-236.
Millen JCA, Hofmann A, Mesquita-Neto JW, Rose J, Macedo FI. Evolving role of liver resection in selected patients with metastatic breast cancer. J Surg Res. 2021;259:363-371.
Franzese C, Comito T, Viganò L, et al. Liver metastases-directed therapy in the management of oligometastatic breast cancer. Clin Breast Cancer. 2020;20(6):480-486.