Abdominoperineal resection and perineal wound healing in recurrent, persistent, or primary anal carcinoma

Hardt, Julia; Mai, Sabine; Weiß, Christel; Kienle, Peter; Magdeburg, Julia

doi:10.1007/s00384-016-2575-9

Cited by 14 publications

(20 citation statements)

References 24 publications

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“…Of these, 21 studies met our predefined eligibility criteria and were included in this systematic review [8][9][10][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The repeat search revealed an additional 28 citations and they were also included in the review [31][32][33][34][35]. The flowchart summarizing the systematic search strategy is given in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The median percentage of men was 28.0% (IQR 19.0%-41.0%). HIV status was reported in 14 studies [9,10,15,16,19,21,22,[27][28][29][30]33,36]; one study inclu ded only patients with HIV [15]. Studies that included both HIV and non-HIV patients did not analyse the outcomes separately within these groups.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…There were two studies in which all patients received 5-fluorouracil (5-FU) with mitomycin C (MMC) [18,22] and one study in which all patients received 5-FU with cisplatin [19]. Seventeen studies had patients who received a combination of 5-FU, MMC and cisplatin [8,9,13,14,16,17,20,21,23,24,27,[30][31][32][33][34]37]. Patients were treated primarily with bleomycin or carboplatin with 5-FU in one study [25].…”

Section: Chemoradiation Therapy Protocolsmentioning

confidence: 99%

“…For the studies that reported long-term outcomes, 19 studies [8,[13][14][15]17,18,[20][21][22][23][24][25][26][27]29,30,33,34] reported survival from the time of salvage APR with a weighted median follow-up time of 24.2 months (IQR 18.0-47.0). Five studies [9,16,19,28,31,34,35] reported survival from diagnosis of persistent or recurrent disease and not the surgical date; the weighted median follow-up time was 33.3 months (IQR 33.3-34.0).…”

Section: Outcomes After Surgerymentioning

confidence: 99%

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A systematic review of outcomes after salvage abdominoperineal resection for persistent or recurrent anal squamous cell cancer

Sarkaria

Merchant

et al. 2019

Colorectal Disease

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Aim Up to 30% of patients with squamous cell cancer of the anus (SCCA) will require a salvage abdominoperineal resection (APR) for either persistent or recurrent disease. The objective of this study was to assess cancer‐related outcomes in patients with (i) persistent or (ii) recurrent SCCA. Method Embase and MEDLINE were searched. Publications were included if they assessed overall survival (OS), disease‐free survival (DFS) and locoregional recurrence or metastatic disease after salvage APR for persistent or recurrent SCCA. Results A total of 28 retrospective case series (study size ranged from nine to 111) met our inclusion criteria. The median time to salvage APR was 2.6 months [interquartile range (IQR) 2.6–5.0 months, six studies] for persistent disease and 27.6 months (IQR 15.0–32.7 months, five studies) for recurrent disease. The median 5‐year OS from the time of salvage APR was 45.0% (IQR 32.0%–52.3%, 10 studies) for persistent disease and 51.0% (IQR 36.0%–60.9%, 11 studies) for recurrent disease. The median 5‐year DFS following salvage APR was 44.0% (IQR 29.5%–53.0%, 10 studies) for all patients. Following salvage APR, the median locoregional recurrence rate was 23.5% (IQR 15.8%– 46.9%, 19 studies) and 9.0% (IQR 6.4%–13.3%, 16 studies) of patients developed metastatic disease after salvage APR. Conclusion Our review characterizes the best evidence for outcomes following salvage APR for patients with persistent or recurrent SCCA. The evidence is limited by the quality of included studies, as many were single centre case series.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Chemoradiation Therapy Protocolsmentioning

confidence: 99%

Section: Outcomes After Surgerymentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of outcomes after salvage abdominoperineal resection for persistent or recurrent anal squamous cell cancer

Sarkaria

Merchant

et al. 2019

Colorectal Disease

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“…Obliteration of the dead space by tissue flaps may decrease the incidence of wound failure . However, donor site morbidity remains a major drawback of currently used autologous transposition flaps such as the rectus abdominis muscle flap and gluteal muscle flap for perineal wound closure after APR . Therefore, there is a need for a transposition flap with less donor site morbidity.…”

mentioning

confidence: 99%

Gluteal turnover flap for perineal reconstruction following abdominoperineal resection for rectal cancer – a video vignette

et al. 2019

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Anal Cancer

Sands

Mahmoud

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Tumors of the anal region are divided into anal and perianal cancers with different paths of lymphatic drainage.• Squamous cell carcinoma (SCC) is the most common type of anal cancer. • Chemoradiotherapy is the mainstay for anal (SCCa). The standard chemotherapy consists of 5-FU and mitomycin. The minimum dose of radiation is 45 Gy to the primary tumor. • Inguinal node metastasis can be diagnosed with PET-CT and managed with radiation. • Surgery for anal canal cancer is limited to very small lesions and salvage situations following failed chemoradiotherapy. • Anal adenocarcinoma can arise from an anal gland or chronic fistula tract. They can be difficult to distinguish from distal rectal cancers. These tumors are staged and treated similar to rectal cancers with a lower overall survival. • Verrucous carcinomas are characterized by large size and lack of invasion. Treatment is mainly wide surgical excision. • Anal melanoma is a rare and aggressive tumor. Survival is very poor. Abdominoperineal resection may help to control local disease but does not prolong life expectancy; therefore, local excision is often a first choice when possible. • Perianal Paget's disease -or intraepithelial adenocarcinoma -is frequently associated with other malignancies.Treatment is focused on surgical excision and may require mapping biopsies to plan resection.• Basal cell carcinoma of the perianal region is treated with wide local excision. • Gastrointestinal stromal tumors can be managed with wide local excision or radical excision depending on margin status. Preoperative treatment with tyrosine kinase inhibitors may enhance resectability.

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Abdominoperineal resection and perineal wound healing in recurrent, persistent, or primary anal carcinoma

Abstract: Salvage APR has a reasonable chance of long-time survival. Perineal reconstruction with a VRAM flap may reduce the duration until completion of perineal wound healing.

Cited by 14 publications

References 24 publications

A systematic review of outcomes after salvage abdominoperineal resection for persistent or recurrent anal squamous cell cancer

A systematic review of outcomes after salvage abdominoperineal resection for persistent or recurrent anal squamous cell cancer

Gluteal turnover flap for perineal reconstruction following abdominoperineal resection for rectal cancer – a video vignette

Anal Cancer

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