G.F. Cedillo1, K. Khanipov1, A. D’Andrea1 1University Of Texas Medical Branch, Surgery, Galveston, TX, USA
Introduction: Chemoradiation therapy enables sphincter preservation for a majority of patients diagnosed with anal squamous cell cancer. That being said, surgery to create a colostomy prior to chemoradiation therapy remains a real possibility for patients, and the rates of colostomy creation and reversal remain understudied.
Methods: We performed a retrospective cohort study using TriNetX, a global federated health research network of electronic health records. In addition to evaluating the incidence of colostomy creation, we sought to identify the rate of colostomy reversal and the factors associated with non-reversal within 5 years of colostomy creation by using 1:1 propensity score matching, expressed as adjusted as adjusted Hazard ratios (aHRs).
Results: Among 40,689 patients who were diagnosed with anal squamous cell cancer, the incidence of colostomy creation was 1,894 (4.6%). Among the patients with pretreatment colostomies, 311 (16.5%) underwent colostomy reversal at an average 277.04 ± 582.629 days. Patients with fecal incontinence were less likely to undergo reversal (5% vs 9.7%, P<0.03). Rectovaginal fistula was also associated with lower rate of reversal, although not statistically significant (6.4% vs 9.5%, P=0.19).
Conclusion: The rates of colostomy creation and reversal are not insignificant. Patients with a new diagnosis of anal squamous cell cancer may be counseled accordingly at the time of their diagnosis.