{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T08:11:07Z","timestamp":1696234267281},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T00:00:00Z","timestamp":1512086400000},"content-version":"vor","delay-in-days":0,"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":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> guidance advises the creation of a defunctioning stoma for anal tumours infiltrating the vagina, impending obstruction or significant faecal incontinence. Other patients may be offered a defunctioning stoma at the discretion of the clinician. The purpose of this study was to establish the prevalence and fate of defunctioning stomas in a regional anal cancer service, with reference to the results from the recent <jats:styled-content style=\"fixed-case\">ACT II<\/jats:styled-content> trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Oncological treatment was standardized as described in the <jats:styled-content style=\"fixed-case\">ACT II<\/jats:styled-content> trial. All patients from 2010 to 2013 inclusive were included. Collected data were correlated with both the <jats:styled-content style=\"fixed-case\">IMRT<\/jats:styled-content> guidelines and the outcomes of the <jats:styled-content style=\"fixed-case\">ACT II<\/jats:styled-content> trial. Kaplan\u2013Meier survival analysis was applied to stoma\u2010free survival to the end of the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010six patients were identified during the study period, of whom 51% had a defunctioning stoma. Twenty were performed for anterior tumours without infiltration into the vagina (Group A), whilst 19 had a stoma for indications as set out by the guidelines (Group B). Stoma reversal was performed in 41% of patients, 13\/20 in Group A and 3\/19 in Group B. The median time to reversal was 11\u00a0months. Eleven deaths were recorded and six patients still had their stomas at time of death. Stoma\u2010free survival was 74%. No new ano\u2010vaginal fistulation occurred as a consequence of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The tumour features that are indications for defunctioning as advised by the <jats:styled-content style=\"fixed-case\">UK IMRT<\/jats:styled-content> guidelines are associated with a poorer overall outcome, and these stomas are less likely to be reversed. The majority of stomas, however, were formed for anterior tumours without infiltration into the vagina and were more likely to be successfully reversed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13855","type":"journal-article","created":{"date-parts":[[2017,8,21]],"date-time":"2017-08-21T09:12:42Z","timestamp":1503306762000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The prevalence and fate of the defunctioning stoma in patients with anal cancer: a regional experience following the <scp>ACT II<\/scp> trial"],"prefix":"10.1111","volume":"19","author":[{"given":"L. R.","family":"Poynter","sequence":"first","affiliation":[{"name":"Department of Laparoscopic, General and Colorectal Surgery Maidstone and Tunbridge Wells NHS Trust Maidstone UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Raman","sequence":"additional","affiliation":[{"name":"The Kent Oncology Centre Maidstone Hospital Maidstone and Tunbridge Wells NHS Trust Maidstone UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Wegstapel","sequence":"additional","affiliation":[{"name":"Department of Laparoscopic, General and Colorectal Surgery Medway NHS Foundation Trust Gillingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Summers","sequence":"additional","affiliation":[{"name":"The Kent Oncology Centre Maidstone Hospital Maidstone and Tunbridge Wells NHS Trust Maidstone UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. A.","family":"Lawes","sequence":"additional","affiliation":[{"name":"Department of Laparoscopic, General and Colorectal Surgery Maidstone and Tunbridge Wells NHS Trust Maidstone UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03409-5"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.9.2527"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.5.2040"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.8085"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70086-X"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13288"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2014.08.001"},{"key":"e_1_2_8_9_1","unstructured":"MuirheadR AdamsRA GilbertDC HarrisonM Glynne\u2010JonesR Sebag\u2010MontefioreD et\u00a0al.National Guidance for IMRT in Anal Cancer.2016.http:\/\/analimrtguidance.co.uk(accessed January 2017)."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2010.02529.x"},{"key":"e_1_2_8_11_1","unstructured":"Canadian Cancer Society.UICC Stages of Anal Cancer.2016.www.cancer.ca\/en\/cancer-information\/cancer-type\/anal(accessed January 2017)."},{"key":"e_1_2_8_12_1","unstructured":"Cancer Research UK.Anal cancer statistics.2014.http:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/anal-cancer(accessed January 2017)."},{"key":"e_1_2_8_13_1","first-page":"2659","article-title":"A case of salvage treatment for local recurrence of squamous cell anal carcinoma after chemoradiation","volume":"37","author":"Goto H","year":"2010","journal-title":"Gan To Kagaku Ryoho"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237308"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1055319"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.234"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1080\/00015458.2013.11680940","article-title":"Meta\u2010analysis of temporary ileostomy versus colostomy for colorectal anastomoses","volume":"113","author":"Chen J","year":"2013","journal-title":"Acta Chir Belg"},{"key":"e_1_2_8_18_1","first-page":"14","article-title":"The sexual health of female rectal and anal cancer survivors: results of a pilot randomized psycho\u2010educational intervention trial","volume":"14","author":"DuHamel K","year":"2015","journal-title":"J Cancer Surviv"},{"key":"e_1_2_8_19_1","first-page":"186","article-title":"Pelvic radiotherapy and sexual function in women","volume":"4","author":"Jensen PT","year":"2015","journal-title":"Transl Androl Urol"},{"key":"e_1_2_8_20_1","first-page":"A5020","article-title":"Patients use normalisation techniques to cope with the quality\u2010of\u2010life effects of anal cancer","volume":"62","author":"Mortensen GL","year":"2015","journal-title":"Dan Med J"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-2879-2"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13076"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12952"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13855","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.13855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:10:04Z","timestamp":1696205404000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.13855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/codi.13855"],"URL":"https:\/\/doi.org\/10.1111\/codi.13855","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12]]},"assertion":[{"value":"2017-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}