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International Journal of Colorectal Disease

, Volume 34, Issue 11, pp 1895–1905 | Cite as

Long-term results achieved by guideline-based stage-dependent management of anal cancer in a non-HIV population

  • Bernhard Fankhaenel
  • Joerg Zimmer
  • Dorothea Bleyl
  • Eric Puffer
  • Andreas Schreiber
  • Thomas Kittner
  • Helmut Witzigmann
  • Sigmar StelznerEmail author
Original Article
  • 37 Downloads

Abstract

Purpose

Therapy of anal cancer follows national and international guidelines that are mainly derived from randomized trials. This study aimed to analyze long-term results of stage-dependent treatment of anal cancer in a non-selected patient cohort.

Patients and method

All consecutive patients treated for anal cancer between 2000 and 2015 were retrieved from a prospective database. Risk-dependent screening for human immunodeficiency virus showed no infection. Main outcome measure was overall survival with respect to tumor site and treatment. Secondary endpoints were cause-specific survival, stoma free survival, and the rate of salvage operations.

Results

In total, 106 patients were treated for anal cancer. Of those, 69 (65.1%) suffered from anal canal cancer and 37 (34.9%) from anal margin cancer. Three patients with synchronous distant metastases were excluded from analysis. The majority of patients (n = 79, 76.7%) were treated by chemoradiotherapy in curative intention. Twenty-two patients underwent local surgery. Five-year overall survival was 73.1% and cause-specific survival at 5 years was 87.4%. Overall, 14 patients (13.6%) needed salvage surgery. Their 5-year cause-specific survival was 57.7%. A permanent ostomy was avoided in 77.7%.

Conclusions

Treatment of anal cancer results in low rates of salvage surgery and permanent ostomies, when therapy was determined by a multidisciplinary team following national and international guidelines.

Keywords

Anal cancer Overall survival Cause specific survival Chemoradiotherapy Salvage surgery 

Notes

Funding information

The maintenance of the database at the Coloproctologic Unit of Dresden-Friedrichstadt General Hospital is supported by a grant from the Tumor Centre Dresden.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General and Visceral SurgeryDresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of DresdenDresdenGermany
  2. 2.Department of Radiation TherapyDresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of DresdenDresdenGermany
  3. 3.Department of Medical OncologyDresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of DresdenDresdenGermany
  4. 4.Department of PathologyDresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of DresdenDresdenGermany
  5. 5.Department of RadiologyDresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of DresdenDresdenGermany

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