Surgical salvage therapy of anal cancer.
OBJECTIVE
To evaluate the results of salvage resection in the management of persistent or locally recurrent anal canal cancer.


METHODS
Details of all patients with anal canal cancer treated from 1978 to 1994 at Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) were reviewed retrospectively. Sixteen patients who presented with persistent or locally recurrent anal canal cancer received salvage surgery. Before surgery all of the patients had received radiotherapy alone as their primary treatments.


RESULTS
Of the 16 patients, 14 received salvage abdominoperineal resection (APR) and two had transanal local excision. There were no deaths attributable to operation. Delayed healing of the perineal wound occurred in eight patients. Complications unrelated to the perineal wound were found in five patients. The median follow-up time was 120 (range 5-245) months after salvage surgery. Nine patients died of disease progression, with a median survival time of 16 (range 5-27) months. Six patients had a long-term survival.


CONCLUSIONS
Salvage resection after radiotherapy can yield a long-time survival in selected patients with anal canal cancer. However it offers little hope to patients with T4 and/or N(2-3) tumors.
Bai
Yue-Kui
YK
Department of General Surgical Oncology, Cancer Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. 5151bai@yahoo.com.cn
Cao
Wen-Lan
WL
Gao
Ji-Dong
JD
Liang
Jun
J
Shao
Yong-Fu
YF
D000005:Abdomen / Q000601:surgery; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D001005:Anus Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D016879:Salvage Therapy; D016019:Survival Analysis