渥太华医院对肛管癌患者的回顾。

Review of anal cancer patients at the Ottawa hospital.

作者信息

Abunassar M, Reinders J, Jonker D J, Asmis T

机构信息

Division of Medical Oncology, Department of Medicine, University of Ottawa, The Ottawa Hospital Cancer Centre, Canada.

出版信息

Eur J Surg Oncol. 2015 May;41(5):653-8. doi: 10.1016/j.ejso.2015.02.004. Epub 2015 Mar 4.

DOI:10.1016/j.ejso.2015.02.004

PMID:25776438

Abstract

BACKGROUND

Anal cancer is uncommon. We reviewed the treatment and outcomes of anal cancer patients in a population referred to the Ottawa Hospital Cancer Centre (TOHCC) over a 12-year period.

METHODS

A chart review was conducted with patient data collected from hospital records, including: demographic, treatment and outcome information. Outcomes of interest included: overall survival (OS), disease free survival (DFS), and colostomy free survival (CFS).

RESULTS

180 patients were included in the study population. 72% (n = 130) female and 28% (n = 50) male. 6.7% (n = 12 males) of patients were HIV positive - all were on anti-retroviral therapy. 60% (n = 108) of patients were ever-smokers, mean patient age was 62 [range 35-90] years. The most frequent presenting symptoms were blood per rectum and anal pain. Treatment intent was curative in 87%. Treatment included radiotherapy (94%), brachytherapy (26%), chemotherapy (73%). Among patients treated with curative-intent, 72% had a complete response, 31% had local/regional recurrence, 16% required salvage surgery and 21% had distant recurrence. The colostomy rate was 23%. 5 year overall survival (OS) was not significantly different for patients by HIV status. Survival was superior if MMC-FU was used first vs. CIS-FU; OS HR 0.47 (0.24-0.94), p < 0.033.

CONCLUSIONS

The outcomes of patients in this large retrospective cohort study are similar to the outcomes of patients in highly selective clinical trials. Five year overall survival and colostomy free survival are encouraging. MMC-FU was found to be superior to CIS-FU.

摘要

背景

肛管癌并不常见。我们回顾了在12年期间转诊至渥太华医院癌症中心（TOHCC）的肛管癌患者的治疗情况及预后。

方法

通过查阅病历对从医院记录中收集的患者数据进行分析，包括人口统计学、治疗及预后信息。关注的预后指标包括：总生存期（OS）、无病生存期（DFS）和无结肠造口生存期（CFS）。

结果

180例患者纳入研究人群。女性占72%（n = 130），男性占28%（n = 50）。6.7%（n = 12例男性）患者HIV阳性，均接受抗逆转录病毒治疗。60%（n = 108）患者曾吸烟，患者平均年龄为62岁[范围35 - 90岁]。最常见的症状是便血和肛门疼痛。87%的患者治疗目的是治愈。治疗方法包括放疗（94%）、近距离放疗（26%）、化疗（73%）。在接受根治性治疗的患者中，72%获得完全缓解，31%出现局部/区域复发，16%需要挽救性手术，21%出现远处复发。结肠造口率为23%。按HIV状态分组，患者的5年总生存期无显著差异。与顺铂 - 氟尿嘧啶相比，先用丝裂霉素 - 氟尿嘧啶治疗患者的生存期更长；总生存期风险比为0.47（0.24 - 0.94），p < 0.033。