Salvage abdominoperineal resection following combined chemotherapy and radiotherapy for epidermoid carcinoma of the anus Journal Article
| Authors: | Ellenhorn, J. D. I.; Enker, W. E.; Quan, S. H. Q. |
| Article Title: | Salvage abdominoperineal resection following combined chemotherapy and radiotherapy for epidermoid carcinoma of the anus |
| Abstract: | Background: Up to one-third of patients with anal epidermoid cancer will fail initial chemoradiotherapy (CT-RT) or have local recurrence after treatment. This study evaluates the Memorial Sloan-Kettering Cancer Center (MSKCC) experience with salvage abdominoperineal resection (APR) in these patients. Methods: Thirty-eight patients who underwent salvage APR following 5-fluorouracil (5-FU), mitomycin C, and radiotherapy over the past 12 years were analyzed by retrospective review. Survival was calculated by the Kaplan-Meier method and comparisons by log-rank analysis. Results: The indications for APR were recurrent disease after CT-RT in 14 patients and persistent disease in 24 patients. Median follow-up time and survival were 47 and 41 months, respectively. The actuarial 5-year survival was 44%. Twenty-three patients had recurrent disease after APR. Inguinal lymphadenopathy at initial presentation (p<0.05), fixation of tumor to the pelvic sidewall (p<0.01), and pathologic involvement of the perirectal fat (p<0.01) adversely affected survival. Age, gender, initial response to CT-RT, initial stage of the primary tumor, histologic levator muscle involvement, status of perirectal lymph nodes, and extent of lymphadenectomy did not affect survival. Conclusions: Salvage APR can be expected to yield a moderate number of long-term survivors, but the high rate of disseminated failure suggests the need for additional postoperative treatment. © 1994 The Society of Surgical Oncology, Inc. |
| Keywords: | adult; aged; aged, 80 and over; treatment failure; salvage therapy; squamous cell carcinoma; carcinoma, squamous cell; multimodality cancer therapy; radiation dose; combined modality therapy; antineoplastic agent; antineoplastic combined chemotherapy protocols; radiotherapy dosage; abdomen; chemoradiotherapy; perineum; abdominoperineal resection; middle age; anal cancer; anus neoplasms; anus tumor; human; male; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 1 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 1994-03-01 |
| Start Page: | 105 |
| End Page: | 110 |
| Language: | English |
| DOI: | 10.1007/bf02303552 |
| PROVIDER: | scopus |
| PUBMED: | 7834434 |
| DOI/URL: | |
| Notes: | Export Date: 14 January 2019 -- Article -- Source: Scopus |
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