Pretreatment colostomy in patients with anal squamous cell carcinoma: Risk factors for a permanent stoma

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art_SOBRADO_Pretreatment_colostomy_in_patients_with_anal_squamous_cell_2022.PDF (653.95 KB)
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
NAHAS, Sergio C.
Citação
JOURNAL OF SURGICAL ONCOLOGY, v.126, n.4, p.740-747, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background The current standard of care for anal squamous cell carcinoma (SCC) is concurrent chemoradiation (CRT), which enables tumor eradication while preserving the anal sphincter. Patients with locally advanced tumors, however, may experience complications that preclude treatment before stoma creation. Objective To evaluate the reversal rate of pretreatment stomas and the risk factors associated with nonreversal. Methods This single-institution retrospective cohort study using a prospective database included patients diagnosed with anal SCC from January 2008 to December 2020 who required a stoma before curative CRT. Results In total, 651 patients were identified; 65 required a stoma before chemoradiation due to obstruction (43.1%), rectovaginal fistula (20%), and perianal sepsis (36.9%). The stoma was reversed in nine patients after a mean follow-up of 35.8 months. Risk factors associated with a permanent stoma were perianal sepsis (p = 0.010), interruptions during radiotherapy for more than 7 days (p = 0.010), male sex (p = 0.013), poor performance status (Eastern Cooperative Oncology Group [ECOG] >= 2) (p = 0.023), large tumors (p = 0.045), and cisplatin-based chemotherapy (p = 0.047). Conclusions Pretreatment stomas are unlikely to be reversed, and risk factors for a permanent stoma are perianal sepsis, interruptions during radiotherapy for more than 7 days, male sex, poor performance status (ECOG >= 2), large tumors, and cisplatin-based chemotherapy.
Palavras-chave
anal cancer, chemoradiation, colostomy, outcomes, squamous cell carcinoma, treatment
URI
https://observatorio.fm.usp.br/handle/OPI/49615
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Coleções
Artigos e Materiais de Revistas Científicas - HC/Outros
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - ODS/03