Risk factors associated with requiring a stoma for the management of anal cancer

Nguyen, W. D., Mitchell, K. M. and Beck, D. F. (2004) Risk factors associated with requiring a stoma for the management of anal cancer. Diseases of the Colon and Rectum, 47 6: 843-846. doi:10.1007/s10350-004-0513-3


Author Nguyen, W. D.
Mitchell, K. M.
Beck, D. F.
Title Risk factors associated with requiring a stoma for the management of anal cancer
Journal name Diseases of the Colon and Rectum   Check publisher's open access policy
ISSN 0012-3706
1530-0358
Publication date 2004-06
Sub-type Article (original research)
DOI 10.1007/s10350-004-0513-3
Volume 47
Issue 6
Start page 843
End page 846
Total pages 4
Place of publication New York, NY, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
PURPOSE: Combination chemotherapy and radiation therapy has become the standard of care for epidermoid carcinoma of the anus, This treatment modality has allowed for preservation of the anus in most patients, sparing them the morbidity of a stoma. Some patients will ultimately require a stoma as a result of salvage surgery or to manage complications of chemoradiotherapy, We hypothesized that tumor characteristics and radiation dose had an impact on the requirement for stoma formation.

METHODS: Data on all patients with epidermoid carcinoma of the anal canal who were treated with chemoradiation with curative intent at Ochsner Clinic Foundation were entered into a prospective registry. We excluded four patients who were lost to follow-up and one patient who died during chemoradiation therapy.

RESULTS: Fifty-one patients were followed for an average of 5.6 years. Primary tumor size average was 3.9 cm. Six patients had Stage I disease, 33 patients had Stage II disease, and 12 patients had Stage III disease (N+ disease). The average radiation dose was 57 ± 17 Gy. Univariate analysis revealed pretreatment tumor size to be the only significant factor associated with the need for a stoma (P = 0.01). Radiation dose was not an important factor (P = 0.38). An additional finding 'was that the pretreatment tumor size and N+ disease were significant predictors of mortality; however, logistic-regression analysis revealed that N+ disease was the only independent predictor of mortality (P = 0.02).

CONCLUSIONS: Patients who have large tumors on presentation should be made aware of the possibility of requiring salvage surgery to treat persistent or recurrent disease. Toxicities from chemoradiotherapy do arise, but patients are not at increased risk for requiring a stoma.
Keyword Anal cancer
Stoma
Radiotherapy
Chemotherapy
Complications
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 08:48:26 EST