A systematic review of outcomes after salvage abdominoperineal resection for persistent or recurrent anal squamous cell cancer
Phase observational
- Population
- People with persistent or recurrent squamous cell cancer of the anus who had salvage abdominoperineal resection
- Design
- Systematic review of Embase and MEDLINE: 28 retrospective case series (study size nine to 111 patients) assessing overall survival, disease-free survival and locoregional recurrence or metastatic disease after salvage abdominoperineal resection for persistent or recurrent anal squamous cell cancer. Results are given as medians with interquartile ranges and the number of contributing studies, not as pooled estimates with confidence intervals; the abstract describes a systematic review, not a meta-analysis.
- Arms
- Salvage abdominoperineal resection (experimental): Salvage abdominoperineal resection for persistent or recurrent disease; observational case series, no comparison group
- People
- Ko G, senior author Patel SV
Show the numbers
| Endpoint | Analysis | Salvage abdominoperineal resection | Control | Effect |
|---|---|---|---|---|
| OSPersistent disease, 10 studies | primaryKo 2019 | 45% at 5 y | — | Median 5-year overall survival from the time of salvage APR for persistent disease, with an interquartile range of 32.0%-52.3% over 10 studies. Median time to salvage APR was 2.6 months (IQR 2.6-5.0 months, six studies). |
| OSRecurrent disease, 11 studies | primaryKo 2019 | 51% at 5 y | — | Median 5-year overall survival from the time of salvage APR for recurrent disease, with an interquartile range of 36.0%-60.9% over 11 studies. Median time to salvage APR was 27.6 months (IQR 15.0-32.7 months, five studies). |
| DFSAll patients, 10 studies | primaryKo 2019 | 44% at 5 y | — | Median 5-year disease-free survival after salvage APR for all patients, with an interquartile range of 29.5%-53.0% over 10 studies. |
| Locoregional failure19 studiesLocoregional recurrence after salvage APR; median rate with an interquartile range over 19 studies. | primaryKo 2019 | 23.5% | — | Median locoregional recurrence rate after salvage APR (interquartile range 15.8%-46.9%, 19 studies). Median proportion who developed metastatic disease after salvage APR was 9.0% (IQR 6.4%-13.3%, 16 studies). The authors note that the evidence is limited by study quality, many being single-centre case series. |
| Endpoint | Analysis | Salvage abdominoperineal resection | Control | Effect |
|---|---|---|---|---|
| OSPersistent disease, 10 studies | primaryKo 2019 | 45% at 5 y | — | Median 5-year overall survival from the time of salvage APR for persistent disease, with an interquartile range of 32.0%-52.3% over 10 studies. Median time to salvage APR was 2.6 months (IQR 2.6-5.0 months, six studies). |
| OSRecurrent disease, 11 studies | primaryKo 2019 | 51% at 5 y | — | Median 5-year overall survival from the time of salvage APR for recurrent disease, with an interquartile range of 36.0%-60.9% over 11 studies. Median time to salvage APR was 27.6 months (IQR 15.0-32.7 months, five studies). |
| DFSAll patients, 10 studies | primaryKo 2019 | 44% at 5 y | — | Median 5-year disease-free survival after salvage APR for all patients, with an interquartile range of 29.5%-53.0% over 10 studies. |
| Locoregional failure19 studiesLocoregional recurrence after salvage APR; median rate with an interquartile range over 19 studies. | primaryKo 2019 | 23.5% | — | Median locoregional recurrence rate after salvage APR (interquartile range 15.8%-46.9%, 19 studies). Median proportion who developed metastatic disease after salvage APR was 9.0% (IQR 6.4%-13.3%, 16 studies). The authors note that the evidence is limited by study quality, many being single-centre case series. |