Role of metastasectomy for liver metastasis in stage IV anal cancer

There is a paucity of data on the role of metastasectomy for metastatic anal cancer on survival outcomes. We aim to define the role of metastasectomy in stage IV anal cancer. National Cancer Database (NCDB) from 2004 to 2014 was accessed to include patients with metastatic anal cancer, excluding ade...

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Bibliographic Details
Published in:The American journal of surgery 2021-04, Vol.221 (4), p.832-838
Main Authors: Goldner, Matthew, Platoff, Rebecca, Betances, Avril, De Leo, Nicholas, Gaughan, John, Hageboutros, Alexandre, Atabek, Umur, Spitz, Francis R., Hong, Young K.
Format: Article
Language:English
Subjects:
Adenocarcinoma
Anal cancer
Anal cancer liver metastases
Anus
Anus Neoplasms - mortality
Anus Neoplasms - pathology
Anus Neoplasms - surgery
Cancer
Cancer therapies
Chi-square test
Colorectal cancer
Comorbidity
Female
Histology
Humans
Liver
Liver cancer
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Lungs
Male
Metastasectomy
Metastasectomy - methods
Metastases
Metastasis
Middle Aged
Mortality
Neoplasm Staging
Retrospective Studies
Surgery
Survival
Survival Rate
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Summary:There is a paucity of data on the role of metastasectomy for metastatic anal cancer on survival outcomes. We aim to define the role of metastasectomy in stage IV anal cancer. National Cancer Database (NCDB) from 2004 to 2014 was accessed to include patients with metastatic anal cancer, excluding adenocarcinoma, neuroendocrine, and ‘other’ histologies. We compared patients undergoing metastasectomy (n = 165) to those who did not have metastasectomy (n = 2093) by age, sex, cancer grade, and site of metastasis, including metastasis to bone, liver, and lung, using chi-square analysis. The primary outcome was overall survival. Patients had equal distribution of metastatic sites between those who underwent metastasectomy versus no metastasectomy: bone (7.64% vs 4.85%, p = 0.22), brain (0.24% vs 0%, p = 1.0), liver (23.22% vs 29.70%, p = 0.07), and lung (11.85% vs 9.09%, p = 0.38). Survival following metastasectomy was increased at one year (71% vs. 61%, p = 0.016), two years (50% vs. 38%, p = 0.014), and five years (30% vs. 19%, p = 0.025). Median overall survival was increased (23 months vs. 16 months; p = 0.015) for patients with metastasectomy. Survival increases were demonstrated only in the group with liver metastasis undergoing metastasectomy. When stratifying for liver metastases only, median overall survival time was further increased (34 months vs. 16 months; p 
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2020.08.016