Single centre outcomes of surgery following chemoradiotherapy for anal cancer

Published Date: 14th August 2018

Publication Authors: Liew S

​Aim

Anal cancer accounts for less than 1% of all cancers but carries considerable morbidity and mortality. We reviewed clinicopathological outcomes for patients undergoing surgery following chemoradiotherapy (CRT) for anal cancer.

Methods

A retrospective review of casenotes from patients undergoing surgery for anal cancer from 2008-2017 was performed. Patients were identified from the anal cancer MDT records and the departmental surgical logbook.

Results

Twenty-eight patients were identified (71% female) with a median (IQR) age of 64 [20.5] years. Twenty-six patients underwent APER and two pelvic exenteration (68% had flap reconstruction). Post-operative complications were identified in 17 (61%) patients, 11 (39%) of which were Clavien-Dindo I-II and 6 (21%) were III-IV. There was one 90 day mortality. The overall 1, 3, and 5 year survival was 79.1%, 50.0% and 36.3% respectively.

Conclusion

Chemoradiotherapy remains the gold standard for the treatment of anal cancer, with salvage surgery preserved for residual or recurrent disease, or for palliation. We report a median time from completion of CRT to surgery of 18.4 months, an R0 resection rate of 6.4% and 5 year survival rate of 36.3%. The reason for low 5 year survival requires analysis. Robust prospective data collection is needed to fully quantify outcomes in this important group.

 

Leptidis, I; Sutton, P; Liew, SH; Rooney, P. (2018). Single centre outcomes of surgery following chemoradiotherapy for anal cancer. International Journal of Surgery. 55 (Suppl 1), S51.

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