Preoperative Chemotherapy and Radiotherapy in the Management of Epidermoid Carcinoma of the Anal Canal

1987 ◽  
Vol 73 (2) ◽  
pp. 151-155 ◽  
Author(s):  
Giovanni Battista Secco ◽  
Mario Roberto Sertoli ◽  
Daniele Scarpati ◽  
Gianni Marino ◽  
Roberto Fardelli ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Partial Response ◽  
Anal Canal ◽  
Complete Response ◽  
Epidermoid Carcinoma ◽  
Preoperative Treatment ◽  
Term Survival ◽  
Initial Surgery

Sixteen patients affected by epidermoid carcinoma of the anal canal were treated preoperatively by means of an i.v. infusion of mitomycin C (15 mg/m2) on day 1 and 5-fluorouracil (750 mg/m2) days 1 to 5, followed by radiotherapy (3000 R in 3 weeks). Four to 6 weeks after the end of radiotherapy the response to the preoperative treatment was evaluated by means of biopsy. A reduction of the neoplastic mass was observed in 13 of the 16 patients. An evident correlation exists between the stage of the tumor and 1) the response to preoperative treatment, 2) local recurrence, and 3) long-term survival. In fact: 3/4 T1 patients reached a complete response (CR), and 1/4 T1, 5/5 T2 and 4/7 T3 patients achieved a partial response (PR); only 3/7 T3 patients never responded to preoperative treatment. After the initial surgery, only T2 (3/5) and T3 (4/7) patients underwent a second operation for a recurrence. Overall survival at 42 months was 62.5 % (T1, 100 %; T2, 80 %; T3, 28.5 2%).

Hemangiopericytoma: long-term outcome revisited

2011 ◽  
Vol 114 (3) ◽  
pp. 747-755 ◽  
Author(s):  
Marco Schiariti ◽  
Pablo Goetz ◽  
Hussien El-Maghraby ◽  
Jignesh Tailor ◽  
Neil Kitchen
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Long Term Outcome ◽  
Free Interval ◽  
Initial Surgery ◽  
The Mean

Object Hemangiopericytomas are rare tumors that behave aggressively with a high rate of local recurrence and distant metastases. With the aim of determining the outcome and response to various treatment modalities, a series of 39 patients who underwent microsurgical resection for primary meningeal hemangiopericytoma over a 24-year period is presented. Methods Patients with hemangiopericytoma were identified from histopathology records and their medical records were analyzed retrospectively by 2 independent reviewers to collect data on surgical treatment, adjuvant therapy, postoperative course, local or distant recurrence, and follow-up. Results Of the 39 patients, 19 were male and 20 were female. Mean patient age was 44.1 years. Thirty-four tumors were intracranial and 5 were spinal. The mean follow-up period was 123 months. Twenty-eight patients developed local recurrence. The recurrence rate at 1, 5, and 15 years was 3.5%, 46%, and 92%, respectively. Extraneural metastasis occurred in 8 patients (26%) at an average of 123 months after initial surgery. Recurrences and metastases were treated by surgical excision, external beam radiation therapy (EBRT), chemotherapy, and/or stereotactic radiosurgery. Adjuvant EBRT following initial surgery was found to extend the disease-free interval from 154 months to 254 months, although it did not prevent the development of metastasis. In those patients with EBRT and complete resection, the mean recurrence-free interval was found to be 126.3 months longer (p = 0.04) and overall survival 126 months longer than without EBRT. Furthermore, adjusting for resection, patients undergoing EBRT had 0.33 times increased risk of recurrence compared with those who did not (p = 0.03). A majority of patients remained able to live independently despite revision surgery for recurrence. Conclusions The mean follow-up of this patient series represents the longest follow-up duration published to date and demonstrates extended survival in a significant number of patients with hemangiopericytoma. Gross-total resection followed by adjuvant EBRT provides patients with the highest probability of an increased recurrence-free interval and overall survival. Prolonged survival justifies long-term follow-up and aggressive treatment of initial, recurrent, and metastatic disease.

Outcomes after chemoradiation alone for adenocarcinoma of the esophagus and gastroesophageal junction.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 138-138
Author(s):  
Anthony Pham ◽  
Karyn A. Goodman ◽  
David H. Ilson ◽  
Yelena Yuriy Janjigian ◽  
Geoffrey Yuyat Ku ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Gastroesophageal Junction ◽  
Complete Response ◽  
Local Failure ◽  
Term Survival ◽  
Trimodality Therapy ◽  
Free Survival ◽  
Kaplan Meier ◽  
Immediate Surgery

138 Background: Definitive chemoradiation (CRT) is a standard treatment for esophageal cancer (EC), particularly squamous cell carcinoma (SCC). However, data for nonsurgical treatment of adenocarcinoma (AC) is limited, and response rates to CRT are lower in AC vs. SCC. Therefore, trimodality therapy is often preferred for AC. However, some patients with AC achieve clinical complete response (cCR) after CRT and decline surgery, or are medically inoperable. We therefore reviewed outcomes after CRT alone for esophageal AC. Methods: All patients receiving full-dose (≥ 50 Gy) CRT without surgery for Stage I-III AC of the esophagus or gastroesophageal junction (GEJ) from 2007-2012 at our institution were included. Complete clinical response (cCR) was defined as negative post-CRT biopsy, or SUVmax ≤ 3 on post-CRT PET if no biopsy was obtained. Local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: 105 patients were included. 11 patients (10%) had T1-2N0 disease; the rest had T3+ or N+ disease. Median follow-up was 49 months. 85 patients (81%) received induction chemotherapy prior to CRT. Median OS was 25 months, with 3/5 year OS of 35% and 20% respectively. 67 patients (64%) had cCR, with median OS of 33 months and 3/5 year OS of 48% and 30%, compared to 15 months in incomplete responders (p<0.001). There were no long-term survivors among incomplete responders. 31 (46%) of cCR patients developed local failure, with 3 and 5 year LRFS of 53% and 46%. Median DMFS was 33 months in cCR patients. Of 10 patients who developed isolated local failure, 6 had salvage surgery, 3 had brachytherapy and 1 had laser ablation. Of these, 3 are alive and 2 are free of disease. Conclusions: This is the largest reported series of CRT alone for esophageal AC. In cCR patients, CRT alone is associated with long-term survival comparable to that expected with trimodality therapy. However, local recurrence still occurs in nearly half of patients with cCR. More study is needed to define which patients with cCR will benefit from immediate surgery after CRT, and improvements in therapy are needed to reduce local failure in patients not eligible for surgery.

Long Term Significance of Response in Multiple Myeloma After Stem Cell Transplantation.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1811-1811
Author(s):  
Joaquin Martínez-López ◽  
Joan Blade ◽  
M. Carmen Gomez del Castillo ◽  
Maria Victoria Mateos ◽  
Adrian Alegre ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Stem Cell ◽  
Partial Response ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Complete Response ◽  
Long Term Follow Up

Abstract Abstract 1811 Poster Board I-837 The prognostic significance of achieving complete remission (CR) in Multiple Myeloma (MM) has finally been accepted. However, available studies have been based on series with a median follow-up around 5 years. This time period is insufficient according to the current life expectation of MM. Aim To establish the real effect of prognosis of the different response categories in a cohort of MM patients treated with autologous stem cell transplantation (ASCT) after long term follow up. Patients and methods Follow-up from diagnosis of 344 MM patients transplanted between 1989 and 1998 has been updated. These patients were previously included in a study aimed at establishing the post-ASCT response significance in MM and to validate the EBMT classification (Br J Haemat 2000;109:438-46). It was possible to update the follow up of 322 patients as at April 2009. At this date 99 patients were alive with a median follow-up form diagnosis of 12.5 years. Response categories and evaluated cases were: i) Complete Response (IF-) (CR), n= 84 ii) near Complete Response (EF-/IF+) (nCR), n= 66 iii) Very good partial response (VGPR) (<90% reduction of M component), n= 66 iv) Partial response PR (reduction of M component between 90-50%), n= 113 v) Stable Disease (SD), n= 12, y vi) Progression (PD), n=14 Survival analyses were performed by Kaplan-Meier curves (log-rank test). Cox logistic regression was employed to establish variables associated with a higher survival. Results Significant differences in overall survival (OS) and event free survival (EFS) were found between CR and nCR groups (p 0.01 and 0.0022, respectively); or between CR and VGPR (p 0.0001 and 0.0035); no differences were detected between nRC and VGPR groups (p 0.21 and 0.99) and between these groups and PR group (p 0.1 y p 0.8). OS and EFS of patients with ED o PD were lower than the rest of the groups. Overall survival at 12 years was 43% in CR patients, 21% in nCR, 20% in VGPR, 30% in PR, 8% in SD and 0% in PD groups. Median survival (OS, EFS respectively) of each group was 91 months and 36 m, 26 m and 21 m, 20 m and 15 m, 31 m and 12 m, 8 m and 5 m, and 6 and 1 month. Land-mark study (10 years) found a plateau phase in OS and EFS after 11 years. Twenty two percent of patients are still alive with stable status between 11 and 15.54 years and only two cases had relapsed in the non CR group. In a regression study for OS, response was only one variable with statistical significance (CR P <0.0000, OR 0.044, IC-95%: 0.020-0.30). Conclusions In MM achieving CR after ASCT is the most important prognostic factor even after long-term follow-up. Relapse rate is very low in patients with >11 years of follow-up, this could mean a cure for patients in CR. Disclosures No relevant conflicts of interest to declare.

Effect of adjuvant chemotherapy following pathologic complete response on long-term survival in rectal cancer: A propensity score matched analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 717-717 ◽  
Author(s):  
Ali Mokdad ◽  
Sergio Huerta ◽  
Rebecca M Minter ◽  
John C. Mansour ◽  
Michael A. Choti ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Clinical Stage ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Rectal Adenocarcinoma ◽  
Complete Response ◽  
Term Survival

717 Background: The role of adjuvant chemotherapy following resection in patients with rectal cancer that achieve pathologic complete response (pCR) after neoadjuvant therapy is unclear. Current data have been limited by small sample size series. This study examined the impact of adjuvant chemotherapy following pCR on overall survival in a national cohort of patients. Methods: Patients with rectal adenocarcinoma were identified in the National Cancer Data Base between 2006 and 2012. Those with locally advanced tumor (clinical stage II or III) that achieved pCR (defined as ypT0N0 in surgical specimens) after neoadjuvant chemoradiotherapy (nCRT) were included in the study. We matched by propensity score patients that received adjuvant chemotherapy (ACT) and patients that did not receive postoperative treatment (no-ACT) controlling for demographic as well as perioperative patient and tumor characteristics. Overall survival was compared using a Cox proportional hazards model. Results: We identified 2,543 patients (ACT: 732, no-ACT: 1,811 patients) with resected locally advanced rectal adenocarcinoma that achieved pCR after nCRT. Among patients that received ACT, 711 were matched with 711 patients in the no-ACT group. Adjuvant chemotherapy was associated with improved overall survival compared to no-ACT (hazard ratio[HR] = 0.46, 95% confidence interval [CI] = 0.29 – 0.75). Overall survivals at 1, 3, and 5 years in the ACT and no-ACT groups were 100% vs 98% (P=0.1), 98% vs 94% (P<0.01), and 94% vs 89% (P<0.01), respectively. In subgroup analyses, adjuvant chemotherapy improved overall survival in patients with clinical stage II (HR = 0.43, 95% CI = 0.22 – 0.85) as well as stage III tumor (OR = 0.50, 95% CI = 0.26 – 0.98). Among patients that received adjuvant chemotherapy, there was no difference in overall survival between single agent and multiagent regimens (HR = 1.37, 95% CI = 0.57 – 3.29). Conclusions: Adjuvant chemotherapy may providea small long-term survival benefit in patients with resected locally advanced rectal cancer and pCR after nCRT.

Achievement of Complete Response Is Important for Longer Overall Survival in Patients with Newly Diagnosed Myeloma: A Single-Institutional Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5115-5115
Author(s):  
Kanichi Iwama ◽  
Tomotaka Ugai ◽  
Hiroki Sugihara ◽  
Masayuki Yamakura ◽  
Masami Takeuchi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Partial Response ◽  
Complete Response ◽  
Novel Agents ◽  
Response To Treatment ◽  
Prognostic Impact ◽  
Female Ratio ◽  
Best Response ◽  
The Impact

Abstract Abstract 5115 INTRODUCTION. Even with the introduction of novel therapeutic agents, including thalidomide, bortezomib, and lenalidomide, multiple myeloma (MM) is an incurable disease. Deeper responses, such as complete response (CR) and very good partial response (VGPR), are major goals of treatment to obtain long-term overall response (OS) and progression-free response (PSF) in patients with MM. Recent large randomized retrospective studies also suggested improved OS and PFS in patients who achieved deeper responses. However, the prognostic impact of achieving CR or VGPR remains controversial. In addition, these studies included selected patients that may not be representative of the general population. Therefore, we analyzed cases in our database to evaluate the impact of treatment response on the outcome of consecutive patients with symptomatic MM who were treated with chemotherapeutic regimens containing novel agents over the past 6 years at our institution in Kamogawa City, Japan. PATIENTS AND METHODS. We included 97 consecutive patients treated at our institution between April 2005 and May 2011. The study population consisted of 56 male and 41 female patients with a median age of 70 years old (range: 45 −90). Due to the rapid changes in treatment modality and government approval of novel agents in myeloma during this period, initial treatment could not be uniformly categorized, but all patients received chemotherapy regimens containing at least one novel agent, including thalidomide, bortezomib, and lenalidomide. These patients were thought to be more representative of the general myeloma population. Seventy-seven (79.4%), 27 (38.6%), and 55 (56.7%) patients received bortezomib-, lenalidomide-, and thalidomide-containing regimens, respectively. Treatment responses were assessed using the International Myeloma Working Group (IMWG) criteria with minor modifications, and the best response to treatment during the course of disease was evaluated. Immunofixation test and serum free light chain measurements were performed for confirmation of CR and stringent CR. OS was calculated from the time of diagnosis until the date of death from any cause or the date on which the patient was last known to be alive. Univariate and multivariate analyses were performed for the following variables: age at diagnosis, International Staging System (ISS), and best response achieved. RESULT. The median age of patients was 71 y.o. (range: 49 −90 y.o.), and the male to female ratio was 56:41. The best responses to treatment were as follows: CR was obtained in 19 cases (19.6%), VGPR in 29 (29.9%), partial response (PR) in 34 (35.0%), and stable disease (SD) or less in 15 (15.4%). Baseline characteristics according to best response achieved in patients who achieved CR, VGPR, PR, and SD or less were similar among the patients ≥70 y.o. vs. ≤70 y.o. Patients' age has no impact on the response to treatment. With a median follow-up of 25 months, Kaplan–Meier estimated 3-year and 5-year overall survival (OS) rates were 67.2% and 35.0%, respectively. The 3- and 5-year OS were 100% in patients with CR, which were significantly superior in patients with VGPR (3-y 70%, 5-y 55.0%) and PR (3-y 60%, 5-y 23.0%). The 3- and 5-year OS were not significantly different between patients with VGPR and PR. Normalization of FLC kappa/Lambda ratio was observed in 15 of 19 (80%) patients with CR, 15 of 29 (51%) with VGPR, 4 of 34 (6.6%) in PR, and in none of 15 (0%) in SD or less. Patients who showed normalization of FLC kappa/Lambda ratio had significant OS benefit compared to those who did not. Proportional hazard Cox models showed that patients with ISS stage I/II had better 5-year OS rate compared to patients with stage III (51%; 20%, P = 0.005). However, there was no association between ISS stage and achievement of CR. CONCLUSION. The results of the present study highlighted the importance of achieving CR, not PR or VGPR, and normalization of FLC kappa/Lambda ratio for obtaining long-term OS in patients with MM regardless of age or ISS stage. Disclosures: No relevant conflicts of interest to declare.

High-dose chemotherapy (HDC) and stem-cell rescue as salvage treatment for germ cell testicular tumors in second- and third-line, and outside clinical trials.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 557-557
Author(s):  
Fernanda Carneiro Ronchi ◽  
Daniel Vilarim Araujo ◽  
Ana Claudia Machado Urvanegia ◽  
José Augusto Rinck
Keyword(s):  
Stem Cell ◽  
Prognostic Factors ◽  
Partial Response ◽  
Cox Regression ◽  
Complete Response ◽  
High Dose ◽  
Testicular Tumors ◽  
Term Survival

557 Background: Germ-cells testicular tumors are the most common cancer in young males, usually curable in early stages. Therefore, only 25% of relapsed patients are long-term survivors. Previous non-randomized studies showed promising results with HDC, however, the only randomized trial did not support this approach. Here we report our experience in a Brazilian academic center Methods: We conducted a retrospective review of all consecutive patients treated with salvage HDC followed by Stem-Cell transplantation at our service (1996 – 2016). Survival curves were estimated by Kaplan-Maier method. Prognostic factors were determined by Cox regression model. Results: We found 36 eligible patients. The cohort median follow-up was 56 months (m). At 2 years 50.4% of the patients were alive, and 46.7% were disease-free. The median overall survival (OS) was not-reached and the median progression-free survival (PFS) was 21.8 m. The overall response-rate was 61.2% (22% had complete response and 39% had partial response). All patients who achieved complete response were alive at the last follow-up, and only one had progressive disease. Out of the patients who achieved partial response, one third were rescued with surgery (46% teratoma, 23% fibrosis, and 31% residual disease). Approximately 80% were alive in 2 years vs 20% not operated. Complete response (vs. others) and HDC as second line treatment (vs. 3rd and 4th) were good prognostic factors, (HR N/A; p 0,03, HR 0.19; CI: 0.04-0.88, p = 0.01 respectively). In 2 years, the OS in patients treated in 2nd line was approximately 80%, 50% for 3rd line, and 0% of those treated in 4th line. 89% of the patients experienced grade 3 toxicity, and 25% grade 4. The most common were neutropenic fever (69%), mucositis (36%) and diarrhea (25%). There were 3 deaths related to the treatment. Conclusions: Patients with complete response have sustained long-term survival, and represent the subgroup with evident benefit of the treatment. Surgery, when feasible, can rescue 80% of the patients with partial response. According to our data, we do not recommend this modality of treatment in 4th line.

scholarly journals Pattern of the First Recurrence Has No Impact on Long-Term Survival after Curative Intent Surgery for Perihilar Cholangiocarcinomas

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Madalina Maria Blaga ◽  
Vladislav Brasoveanu ◽  
Cezar Stroescu ◽  
Mihnea Ionescu ◽  
Irinel Popescu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Median Overall Survival ◽  
Recurrence Rates ◽  
Curative Intent ◽  
Term Survival ◽  
Long Term Survival ◽  
First Recurrence ◽  
Isolated Local Recurrence

Aim. To explore the pattern of the first recurrence and impact on long-term survival after curative intent surgery for perihilar cholangiocarcinomas (PHC). Materials and Methods. Patients with curative intent surgery for PHC between 1996 and 2017 were analyzed. Survival times were estimated using the Kaplan-Meier method. Comparisons were made with the log-rank test. Results. A number of 139 patients were included. The median overall survival was 26 months. A recurrence was observed in 86 patients (61.9%), during a median follow-up time of 89 months. The median disease-free survival was 21 months with 1-, 3-, 5-, and 10-year estimated recurrence rates of 38%, 60%, 69%, and 77%, respectively. A number of 57 patients (41%) developed distant only recurrence, while 26 patients (18.7%) presented local and distant recurrences. An isolated local recurrence was observed in 3 patients (2.2%). The median overall survival was 15 months for patients with local recurrence, 15 months for patients with liver metastases, and 17 months for patients with peritoneal carcinomatosis (p=0.903) as the first recurrence. Conclusion. Curative intent surgery for PHC is associated with high recurrence rates. Most patients will develop distant metastases, while an isolated local recurrence is uncommon. The pattern of recurrence does not appear to have a significant impact on survivals.

scholarly journals CNS Hodgkin lymphoma

Blood ◽  
2008 ◽  
Vol 112 (5) ◽  
pp. 1658-1661 ◽  
Author(s):  
Elizabeth R Gerstner ◽  
Lauren E Abrey ◽  
David Schiff ◽  
Andrés J. M Ferreri ◽  
Andrew Lister ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Median Overall Survival ◽  
Complete Response ◽  
Response To Treatment ◽  
Cns Involvement ◽  
Term Survival ◽  
Relapsed Disease

Abstract Central nervous system (CNS) involvement by Hodgkin lymphoma (HL) is rare. As a result, there is limited guidance for clinicians on how to manage these patients. Detailed information was collected on 16 patients, the largest number to date, with meningeal or parenchymal CNS-HL confirmed by histopathology (15) or CSF (1). Eight patients presented with CNS-HL at diagnosis, 2 of whom had isolated CNS disease, while 8 patients developed CNS-HL at relapse. Patients received a range of treatments including surgery or radiation alone, radiation with chemotherapy, or chemotherapy alone. Median overall survival for all 16 patients was 60.9 months from first diagnosis of HL (systemic or CNS) and 43.8 months from diagnosis of CNS-HL. Although a majority of patients have died, long-term survival is possible in patients who achieve a complete response to treatment, particularly those who present with CNS involvement or involvement of the CNS is the sole site of relapsed disease.

scholarly journals Efficacy of the EDP-M Scheme Plus Adjunctive Surgery in the Management of Patients with Advanced Adrenocortical Carcinoma: The Brescia Experience

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 941 ◽  
Author(s):  
Marta Laganà ◽  
Salvatore Grisanti ◽  
Deborah Cosentini ◽  
Vittorio Domenico Ferrari ◽  
Barbara Lazzari ◽  
...  
Keyword(s):  
Partial Response ◽  
Disease Progression ◽  
Adrenocortical Carcinoma ◽  
Residual Disease ◽  
Progression Free Survival ◽  
Complete Response ◽  
Term Survival ◽  
Free Survival ◽  
Ki67 Expression

Etoposide, doxorubicin and cisplatin plus oral mitotane (EDP-M) comprise the reference regimen in the management of patients with adrenocortical carcinoma (ACC). In this paper, we described the outcome of 58 patients with advanced/metastatic ACC consecutively treated with EDP-M in a reference center for this rare disease in Italy. In this series, EDP-M obtained a partial response in 50% of patients; median progression free survival (PFS) and overall survival were 10.1 months (95% Confidence Interval [CI 95%] 8.1–12.8) and 18.7 months (95% CI: 14.6–22.8), respectively. EDP-M was not interrupted in five patients showing disease progression after two cycles without the appearance of new lesions and mitotane levels below the therapeutic range. In two of them, the disease remained stable at further imaging evaluations and the other three obtained a partial response. Twenty-six responding patients underwent surgery of residual disease and 13 of them became disease free. Surgery identified a pathological complete response (pCR) in four patients (7%) and Ki67 expression in post-chemotherapy tumor specimens, inferior to 15% (median value), was associated with better PFS and survival. In the present study, the EDP-M regimen is confirmed to have a limited efficacy. Early disease progression does not mean treatment inefficacy. Surgery of residual disease in partially responding patients allows for the detection of pCR in few of them and this condition is predictive of long-term survival. Ki67 expression of post-chemotherapy residual disease could be an additional prognostic factor that deserves to be studied further.

scholarly journals SALVAGE SURGERY FOR ANAL CANAL CA. LONG TERM OUTCOMES FROM A TERTIARY REFERRAL CENTRE

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Awais Amjad Malik ◽  
Syed Hasan Raza ◽  
Irfan-ul-Islam Nasir ◽  
M Fahd Shah ◽  
Tabinda Sadaf ◽  
...  
Keyword(s):  
Anal Canal ◽  
Salvage Surgery ◽  
Demographic Data ◽  
Complete Response ◽  
Treatment Modalities ◽  
Tertiary Referral Centre ◽  
Term Survival ◽  
Anal Canal Carcinoma ◽  
Line Of Therapy

Purpose: The purpose of this study was to analyse the outcome of salvage surgery in the management of anal canal cancer.Methodology: All patients with a diagnosis of anal canal carcinoma from 2006 to 2015 were studied. Basic demographic data were recorded. Treatment modalities used were recorded for all patients. Long-term surgical outcomes were recorded. Median survival in months was recorded. All data were recorded in the SPSS ver. 20.Results: A total of 62 patients were included in the study. Median age was 51. 38 patients had SCCa on histology and 24 had an adenocarcinoma. 52% of patients had a T4 lesion. Chemoradiotherapy (CRT) was offered to 59 (95%) patients as the first line of therapy. 12 (19%) patients had a complete response. 37 (60%) patients had a partial and 10 (16%) patients had no response to chemoradiation. Salvage surgery was offered to 27 patients. Of these, 21 had a curative resection. Six had irresectable disease and underwent a colostomy only. Median overall survival for all patients was 46 months with a 5-year survival of 55%. Patients with partial response who were offered salvage surgery the 5-year survival were 40%. For patients with no response or progressive disease after chemoradiation therapy, the 5-year survival was 20%.Conclusion: Long-term survival can be achieved in majority of patients who undergo radical salvage surgery after failed CRT for carcinoma of the anal canal.Key words: Adenocarcinoma, anal canal, chemoradiotherapy, surgery

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