Most Colostomies After Anal Cancer Therapy Tumor Related
Large tumor size, history of prior excision tied to tumor-, therapy-related colostomy, respectively
WEDNESDAY, Aug. 10 (HealthDay News) -- Most colostomies performed following radiotherapy or chemoradiotherapy for anal cancer are tumor related, with one-third therapy related, according to a study published online Aug. 8 in the Journal of Clinical Oncology.
Kåre G. Sunesen, from the Aarhus University Hospital in Denmark, and colleagues investigated cause-specific colostomy rates following curative-intent radiotherapy or chemoradiotherapy in 235 patients with anal cancer (diagnosed between 1995 and 2003). The prognostic impact of clinicopathologic variables associated with tumor- or therapy-related colostomy rate was evaluated. Data were collected from Danish national registries and medical records of patients. Patients were followed up from completion of radiotherapy until 2008. Treating colostomy and death as competing events, the cumulative incidence of tumor- and therapy-related colostomy was computed. Hazard ratios (HRs) were used to compare the cumulative incidence of cause-specific colostomies between age, gender, tumor size, chemotherapy, and local excision before radiotherapy.
The investigators found that the five-year cumulative incidence for tumor-related colostomy was 26 percent, and for therapy-related colostomy it was 8 percent. Compared to tumor size of 4 cm, tumor size greater than 6 cm was a risk factor for tumor-related colostomy (adjusted HR, 3.8), while local excision before radiotherapy was a risk factor for therapy-related colostomy (adjusted HR, 4.5).
"One-third of patients with anal cancer had a colostomy after curative-intent radiotherapy or chemoradiotherapy. Most colostomies were tumor related, although one-third were therapy related," the author writes.