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International Journal of Colorectal Disease

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01-02-2018 | Original Article

Anal canal squamous cell cancer: are surgical alternatives to chemoradiation just as effective?

Authors: Kunal Suradkar, Emmanouil E. Pappou, Steven A. Lee-Kong, Daniel L. Feingold, Ravi P. Kiran

Published in: International Journal of Colorectal Disease | Issue 2/2018

Abstract

Purpose

The purpose of this paper is to study long-term oncologic outcomes after different treatment strategies for anal canal cancer (SCAC).

Methods

Patients with SCAC (2004–2013) were identified from Surveillance, Epidemiology, and End Results (SEER) database. Patients undergoing radiation (RT) were compared to those undergoing local excision (LE), abdominoperineal resection (APR), and abdominoperineal resection after radiation (RT + APR). Overall survival (OS) and cancer-specific survival (CSS) data were evaluated using Kaplan-Meier and Cox regression.

Results

Two thousand seven hundred and seventy-two (83.8%) patients underwent RT, 382 (11.6%) LE, 77 (2.3%) APR, 76 (2.3%) RT + APR. Median age for the four groups was 60, 57, 64, and 56 years and 32, 49.7, 53.2, and 39.5% were male, respectively, while median tumor size was 4.4, 2.6, 5.3, and 5.5 cm, respectively. Five-year OS of RT, LE, APR, and RT + APR groups was 63.7, 79.6, 25.8, and 41.8% while CSS was 79.6, 92.5, 75.6, and 58.8%, respectively, (p < 0.001). Adjusted hazard ratios for OS for LE, APR, and RT + APR with RT as reference were 1.007 (0.702-1.444), 2.311 (1.367-3.906), and 2.072 (1.016-4.228), respectively.

Conclusion

These data suggest that APR does not provide better outcomes in treatment of SCAC. Chemoradiation remains the gold standard treatment for majority of patients. Local excision is associated with favorable outcomes in some circumstances.

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Title: Anal canal squamous cell cancer: are surgical alternatives to chemoradiation just as effective?
Authors: Kunal Suradkar
Emmanouil E. Pappou
Steven A. Lee-Kong
Daniel L. Feingold
Ravi P. Kiran
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2938-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anal canal squamous cell cancer: are surgical alternatives to chemoradiation just as effective?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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