[Results of surgical treatment of residual and recurrent anal tumors].
Radio- or chemotherapy is a modern standard of anal cancer treatment. Recurrence or partial remission rate after radiochemotherapy achieves 20-40%. The study is aimed to evaluate the role of abdominoperineal resection in the treatment of residual and recurrent anal cancer. 120 patients (aged from 30 to 81 (59+/-11) years, men:women ratio--1:9) were prospectively studied in the period of 1995 to 2007. The TNM distribution was as follows: T1-2N0M0--66(55.0%), T3-4N0M0--18(15.0%), T1-2N1-3M0--15(12.5%) and T3-4N1-3M0--21(17.5%) patients. The radiotherapy delivered in a dose range of 55-65 Gy was used alone or in combination with chemotherapy with 5-fluoruracil, mitomycin C or Xeloda. The complete tumor regression after radiotherapy/radiochemotherapy was achieved in 74(61.1%) of 120 patients with cancer-specific survival rate of 81.7%. Partial tumor regression was registered in 46 of 120 patients. The abdominoperineal resection was performed in 39(84.8%) of patients with the residual tumor. Thus, surgical treatment allowed secondary local tumor control in 76.9% of patients with the 5-year survival rates of 69.0%. The median survival time for the non-operated patients, including those, received an extra course of radiotherapy, was 19 months. The locoregional tumor relapse was diagnosed in 10(13.74%) of 74 patients with the complete tumor regression. The use of abdominoperineal resection allowed the secondary local tumor control and 5 year survival. Thus, abdominoperineal resection remains the method of choice in the treatment of residual and recurrent anal tumors.
Vorob'ev
G I
GI
Shelygin
Iu A
IuA
Nechushkin
M I
MI
Rybakov
E G
EG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000379:methods*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D009367:Neoplasm Staging; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome