{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:19:44Z","timestamp":1789147184325,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T00:00:00Z","timestamp":1475539200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to investigate the results of salvage abdominoperineal excision (<jats:styled-content style=\"fixed-case\">APR<\/jats:styled-content>) in patients with persistent or recurrent squamous cell carcinoma of the anus (<jats:styled-content style=\"fixed-case\">SCCA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients with anal neoplasia were identified from a prospective database. Patients with invasive <jats:styled-content style=\"fixed-case\">SCCA<\/jats:styled-content> with demonstrated failure of chemoradiation therapy (<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>) who underwent salvage <jats:styled-content style=\"fixed-case\">APR<\/jats:styled-content> for one of three disease categories (persistent, &lt;\u00a06\u00a0months post\u2010<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>; early recurrent, 6\u201324\u00a0months post\u2010<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>; late recurrent, &gt;\u00a024\u00a0months post\u2010<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>) were included. The primary outcome was overall survival after salvage <jats:styled-content style=\"fixed-case\">APR<\/jats:styled-content>. Tumour size, metastatic lymph nodes (<jats:styled-content style=\"fixed-case\">LN<\/jats:styled-content>), circumferential resection margin positivity (<jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content>) and neurolymphovascular invasion (<jats:styled-content style=\"fixed-case\">NLVI<\/jats:styled-content>) were correlated with the outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six patients with a median 3\u2010year overall survival of 46% (median follow\u2010up 24\u00a0months) underwent salvage <jats:styled-content style=\"fixed-case\">APR<\/jats:styled-content> due to persistent or recurrent <jats:styled-content style=\"fixed-case\">SCCA<\/jats:styled-content> (14 men, mean age 59\u00a0years). Eleven (31%) patients were diagnosed with persistent disease, 17 (47%) with early and 8 (22%) with late recurrence. Two\u2010year overall survival of Stage 0\/I\/<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> disease was 81.5% and 33.74%, respectively (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.022). Overall disease stage was associated with disease categorization (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.009): patients with persistent disease or early recurrence had a significantly higher disease stage than patients with late recurrence (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a020.9 and 17.2). Despite apparently improved survival in patients with late disease recurrence on live table analysis, no significant difference was identified in overall survival when stratified by disease category on log\u2010rank test analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Persistent and recurrent disease does not show any significant difference in survival, but patients with late recurrence may have a better prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13288","type":"journal-article","created":{"date-parts":[[2016,2,6]],"date-time":"2016-02-06T02:01:58Z","timestamp":1454724118000},"page":"959-966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Survival following salvage abdominoperineal resection for persistent and recurrent squamous cell carcinoma of the anus: do these disease categories affect survival?"],"prefix":"10.1111","volume":"18","author":[{"given":"N. P.","family":"Severino","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Florida Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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