Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus
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Wiley
2025
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| author | Naseer Baloch A. Kiasat Mikael Machado Jonas Nygren Per J. Nilsson |
| author_facet | Naseer Baloch A. Kiasat Mikael Machado Jonas Nygren Per J. Nilsson Naseer Baloch A. Kiasat Mikael Machado Jonas Nygren Per J. Nilsson |
| collection | Wiley Open Access |
| contents | Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus Naseer Baloch A. Kiasat Mikael Machado Jonas Nygren Per J. Nilsson Colorectal Disease AbstractAimPerineal wound complications are common following salvage surgery in anal cancer. It is not fully known if healing disorders have an impact on oncological outcomes. The aim of this study is to investigate survival in relation to perineal healing status at 3 months after surgery.MethodA retrospective cohort study including all patients with squamous cell anal cancer operated on between January 2005 and June 2020 in Stockholm, Sweden was undertaken. Data collection was by registers and supplemented by chart review. All patients were followed until death or 31 December 2020. Perineal healing status at 3 months was used as a landmark. Association between healing status and recurrence free (RFS) and overall survival (OS) were evaluated using the Cox proportional hazard regression model.ResultsThe final study population comprised 122 patients (78 women). At the landmark date, 73 patients (60%) had a healed perineum and 49 (40%) an unhealed perineum. The R0 resection rate was 92% (112 patients). Follow‐up ranged between 6 and 185 months. Five‐year OS and RFS for all patients was 62% and 56%, respectively. OS was 71% vs. 48% and RFS was 65% vs. 43% for patients with healed versus unhealed wound at the landmark date, respectively. Healing status was significantly associated with OS in univariable analysis (HR 0.52, p = 0.021) and RFS showed a trend (p = 0.054) in the same direction. In a multivariable analysis adjusting for age, gender and T‐stage a statistically significant difference was found concerning OS (HR = 0.47, 95% CI 0.26–0.85) and a trend in the same direction for RFS (HR = 0.60, 95% CI 0.34–1.06).ConclusionThe hypothesis that an unhealed perineal wound following salvage surgery for patients with squamous cell anal carcinoma not only constitutes a surgical but also an oncological problem is strengthened by this study. 10.1111/codi.70130 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1111/codi.70130 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_70130 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus Naseer Baloch A. Kiasat Mikael Machado Jonas Nygren Per J. Nilsson Colorectal Disease Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus Naseer Baloch A. Kiasat Mikael Machado Jonas Nygren Per J. Nilsson Colorectal Disease AbstractAimPerineal wound complications are common following salvage surgery in anal cancer. It is not fully known if healing disorders have an impact on oncological outcomes. The aim of this study is to investigate survival in relation to perineal healing status at 3 months after surgery.MethodA retrospective cohort study including all patients with squamous cell anal cancer operated on between January 2005 and June 2020 in Stockholm, Sweden was undertaken. Data collection was by registers and supplemented by chart review. All patients were followed until death or 31 December 2020. Perineal healing status at 3 months was used as a landmark. Association between healing status and recurrence free (RFS) and overall survival (OS) were evaluated using the Cox proportional hazard regression model.ResultsThe final study population comprised 122 patients (78 women). At the landmark date, 73 patients (60%) had a healed perineum and 49 (40%) an unhealed perineum. The R0 resection rate was 92% (112 patients). Follow‐up ranged between 6 and 185 months. Five‐year OS and RFS for all patients was 62% and 56%, respectively. OS was 71% vs. 48% and RFS was 65% vs. 43% for patients with healed versus unhealed wound at the landmark date, respectively. Healing status was significantly associated with OS in univariable analysis (HR 0.52, p = 0.021) and RFS showed a trend (p = 0.054) in the same direction. In a multivariable analysis adjusting for age, gender and T‐stage a statistically significant difference was found concerning OS (HR = 0.47, 95% CI 0.26–0.85) and a trend in the same direction for RFS (HR = 0.60, 95% CI 0.34–1.06).ConclusionThe hypothesis that an unhealed perineal wound following salvage surgery for patients with squamous cell anal carcinoma not only constitutes a surgical but also an oncological problem is strengthened by this study. 10.1111/codi.70130 http://creativecommons.org/licenses/by/4.0/ |
| title | Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.70130 |