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15. Patient reported long‐term side effects from treatment on urinary and sexual function in anal cancer survivors – 3‐ and 6‐year results from the Swedish national ANCA study.

Author

Axelsson, Anna, Johansson, Mia, Haglind, Eva, Li, Ying, Nilsson, Per J., and Angenete, Eva

Subjects
ANAL cancer, CANCER survivors, SEXUAL intercourse, URINARY incontinence, LOGISTIC regression analysis, CANCER treatment
Abstract

Aim: The standard treatment for anal cancer is chemoradiotherapy. Most patients survive anal cancer but remain living with long‐term side effects related to the treatment received. The aim of this study was to assess the occurrence of long‐term impairment of urinary and sexual function at 3 and 6 years after diagnosis and to investigate the additive effect from chemotherapy in combined chemoradiotherapy on urinary incontinence, compared to radiotherapy alone. Method: The ANal CAncer study (ANCA) is based on a national Swedish cohort of patients diagnosed with anal cancer between 2011 and 2013. All identified patients within the study were invited to respond to a study‐specific questionnaire at 3 and 6 years. Descriptive analyses for the primary endpoint were performed. To investigate a possible additional effect from chemotherapy logistic regression was used. Results: A total of 388 patients were included in the study. At 3 years 264 patients were alive and invited to respond to an anal cancer specific questionnaire. The 3‐ and 6 year response rates were 195 (74%) and 155 patients (67%), respectively. The patient reported urinary function impairment at 3 years were urgency (63%), incomplete bladder emptying (47%), and incontinence (46%) and there was an absolute increase of the prevalence of urinary dysfunction in about 10% at 6 years. Three years after diagnosis, 77% reported that intercourse was not part of their sex life; this percentage increased at 6 years to 83%. We found no negative effect of chemotherapy in combined chemoradiotherapy versus radiotherapy alone on patient reported urinary incontinence. Conclusion: For anal cancer survivors, urinary function was impaired after 3 years and continued to deteriorate as measured at 6 years after diagnosis. Anal cancer and its treatment negatively affected sexual function for both men and women. This may explain why patients reported that sexual activity and frequency of intercourse was not of importance in their life. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Patient reported long‐term side effects on bowel function and anal pain in anal cancer survivors – 3‐ and 6‐year results from the Swedish national ANCA study.

Author

Axelsson, Anna, Johansson, Mia, Haglind, Eva, Li, Ying, Nilsson, Per J., and Angenete, Eva

Subjects
ANAL cancer, CANCER pain, CANCER survivors, LOGISTIC regression analysis, CANCER treatment, CANCER diagnosis
Abstract

Aim: The primary therapeutic option for anal cancer treatment is chemoradiotherapy resulting in 80% survival. The aim of this study was to assess long‐term bowel function impairment and anal pain at 3 and 6 years after anal cancer diagnosis, based on a hypothesis of an increase in impairment over time. A secondary aim was to investigate if chemoradiotherapy increased the risk for bowel impairment, compared to radiotherapy alone. Method: The ANal CAncer study (ANCA) consists of a national Swedish cohort of patients diagnosed with anal cancer between 2011–2013. Patients within the study were invited to respond to a study‐specific questionnaire at 3‐ and 6‐years after diagnosis. Descriptive analyses for the primary endpoint and ordinal logistic regressions for secondary endpoint were performed. Results: A total of 388 patients (84%) were included in the study. At 3 years of follow‐up, 264 patients were alive. A total of 195 of these patients (74%) answered a study specific questionnaire, and at 6 years 154 patients (67%). Fifty‐seven percent experienced bowel urgency at both 3 and 6 years. There was an increased risk for repeated bowel movement within 1 h (OR 2.44 [95% CI: 1.08–5.61, p = 0.03]) at 3 years in patients who had been treated by chemoradiation compared to radiotherapy alone. Conclusions: Impairment in bowel function and anal pain after anal cancer treatment should be expected and remains after 6 years. This suggests that long‐term follow‐up may be necessary in some form after customary follow‐up. The addition of chemotherapy increases long‐term side effects of bowel function. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Conversions in laparoscopic surgery for rectal cancer

Author

van der Pas, Martijn H. G. M., Deijen, Charlotte L., Abis, Gabor S. A., de Lange-de Klerk, Elly S. M., Haglind, Eva, Fürst, Alois, Lacy, Antonio M., Cuesta, Miguel A., Bonjer, Hendrik J., d’Hoore, André, Birch, Dan, DeGara, Chris, Jamieson, Chris, Peiman, Poornoroozy, Jensen, Karl Juul, Bulut, Orhan, Jess, Per, Rosenberg, Jacob, Harvald, Thomas, Ovesen, Henrik, Iesalnieks, Igors, Agha, Ayman, Jaeger, Christina, Kreis, Martin, Kasparek, Michael, Fürst, Alois, Liebig-Hoerl, Gudrun, Kim, Seon Hahn, Bonjer, Jaap, van der Peet, Donald, Cuesta, Miguel, van der Pas, Martijn, Buunen, Mark, Abis, Gabor, Deijen, Charlotte, de Lange-de Klerk, Elly, Hop, Wim, Neijenhuis, Peter, Coene, Peter Paul, van der Harst, Edwin, van ‘t Riet, Yvonne, Bemelman, Willem, Gerhards, Michael, Prins, Hubert, Targarona, Eduardo, Balague, Carmen, Martinez, Carmen, Osorio, Juan Franco, Molina, Garcia, Lacy, Antonio, Delgado, Salvadora, Lujan, Juan, Valero, Graciela, Alonso-Poza, Alfredo, Losadar, Manual, Argudo, Salvador, Lackberg, Zoltan, Skullman, Stefan, Kurlberg, Goran, Haglind, Eva, Andersson, John, Angenete, Eva, Ekelund, Jan, Kressner, Ulf, Matthiessen, Peter, and For the COLOR II study group

Published
2017
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42. Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Author

Deijen, Charlotte L., Vasmel, Jeanine E., de Lange-de Klerk, Elly S. M., Cuesta, Miguel A., Coene, Peter-Paul L. O., Lange, Johan F., Meijerink, W. J. H. Jeroen, Jakimowicz, Jack J., Jeekel, Johannes, Kazemier, Geert, Janssen, Ignace M. C., Påhlman, Lars, Haglind, Eva, Bonjer, H. Jaap, Hellberg, R., Haglind, E., Kurlberg, G., Lindgren, P. G., Lindholm, E., Påhlman, L., Dahlberg, M., Raab, Y., Anderberg, B., Ewerth, S., Janson, M., Åkerlund, J. E., Smedh, K., Montgomery, A., Skullman, S., Nyström, P. O., Kald, A., Wänström, A., Dàlen, J., Svedberg, I., Edlund, G., Kressner, U., Öberg, A. N., Lundberg, O., Lindmark, G. E., Heikkinen, T., Morino, M., Giraudo, G., Lacy, A. M., Delgado, S., Macarulla Sanz, E., Díez, J. Medina, Schwandner, O., Schiedeck, T. H., Shekarriz, H., Bloechle, C., Baca, I., Weiss, O., Msika, S., Desvignes, G., Campbell, K. L., Cuschieri, A., Bonjer, H. J., Schouten, W. R., Kazemier, G., Lange, J. F., van der Harst, E., Coene, P. P. L. O., Plaisier, P., Bertleff, M. J. O. E., Cuesta, M. A., van der Broek, W., Meijerink, W. J. H. J., Jakimowicz, J. J., Nieuwenhuijzen, G., Maring, J., Kivit, J., Janssen, I. M. C., Spillenaar-Bilgen, E. J., Berends, F., and On behalf of the COLOR (COlon cancer Laparoscopic or Open Resection) study group

Published
2017
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47. Survival in relation to time to start of curative treatment of colon cancer: A national register‐based observational noninferiority study.

Author

Rydbeck, Daniel, Bock, David, Haglind, Eva, Angenete, Eva, and Onerup, Aron

Subjects
COLON cancer, COLON cancer diagnosis, SURGICAL emergencies, CANCER treatment, COVID-19 pandemic, LENGTH of stay in hospitals
Abstract

Aim: There are ample discussions regarding the timing of treatment, especially in the era after Covid that caused delay to treatment. The aim of this study was to determine whether a delayed start to curative treatment, within 29–56 days after a diagnosis of colon cancer, was noninferior to starting treatment within 28 days, with regard to all‐cause mortality. Method: This is a national register‐based observational noninferiority study, with a noninferiority margin of hazard ratio (HR) 1.1, including all patients treated with curative intent for colon cancer in Sweden between 2008 and 2016. The primary outcome was all‐cause mortality. Secondary outcomes were length of hospital stay, readmissions and reoperations within 1 year after surgery. Exclusion criteria were emergency surgery, disseminated disease at diagnosis, missing diagnosis date and treatment for another cancer 5 years before colon cancer diagnosis. Results: A total of 20 836 individuals were included. A period of 29–56 days from diagnosis to start of curative treatment was noninferior versus starting treatment within 28 days for the primary outcome of all‐cause mortality (HR 0.95, 95% CI 0.89–1.00). Starting treatment within 29–56 days was associated with a shorter length of stay (average 9.2 vs. 10 days) but a higher risk of reoperation compared to within 28 days. Post hoc analyses demonstrated that surgical modality was driving survival rather than time to treatment. Overall survival was greater after laparoscopic surgery (HR 0.78, 95% CI 0.69–0.88). Conclusion: For patients with colon cancer, a period of up to 56 days from diagnosis to the start of curative treatment did not lead to worse overall survival. [ABSTRACT FROM AUTHOR]

Published
2023
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