Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal

Analysis of patients from the national cancer data base

Karl Y Bilimoria, David Jason Bentrem, Colin E. Rock, Andrew K. Stewart, Clifford Y. Ko, Amy L Halverson

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

PURPOSE: The objective of this study was to assess survival and prognostic factors for anal carcinoma in the population. METHODS: Patients with squamous-cell carcinoma of the anal canal were identified from the National Cancer Data Base (1985Y2000). Univariate and multivariable methods were used to assess factors associated with survival. Concordance was calculated to assess agreement between American Joint Committee on Cancer stage and actual outcome. RESULTS: Nineteen thousand one hundred ninety-nine patients with anal carcinoma were identified (Stage I, 25.3 percent; Stage II, 51.8 percent; Stage III, 17.1 percent; Stage IV, 5.7 percent). Overall five-year survival was 58.0 percent. The American Joint Committee on Cancer (6th edition) staging system provided good survival discrimination by stage: I, 69.5 percent; II, 59.0 percent; III, 40.6 percent; and IV, 18.7 percent (concordance index, 0.663). On multivariable analysis, patients with anal carcinoma had a higher risk of death if they were male, ≥65 years old, black, living in lower median incomes areas, and had more advanced T stage tumors, nodal or distant metastases, or poorly differentiated cancers (P < 0.0001). There was not a significant difference in survival by hospital type or year of diagnosis. CONCLUSION: Although tumor characteristics and staging affect prognosis, patient factors, such as gender, race, and socioeconomic status, are also important prognostic factors for squamous-cell carcinoma of the anal canal.

Original languageEnglish (US)
Pages (from-to)624-631
Number of pages8
JournalDiseases of the Colon and Rectum
Volume52
Issue number4
DOIs
StatePublished - Apr 1 2009

Fingerprint

Anal Canal
Squamous Cell Carcinoma
Databases
Survival
Neoplasms
Carcinoma
Neoplasm Staging
Social Class
Neoplasm Metastasis
Population

Keywords

  • Anal carcinoma
  • Chemotherapy
  • Disparities
  • National Cancer Data Base
  • Radiation
  • Staging
  • Surgery
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal: Analysis of patients from the national cancer data base",
abstract = "PURPOSE: The objective of this study was to assess survival and prognostic factors for anal carcinoma in the population. METHODS: Patients with squamous-cell carcinoma of the anal canal were identified from the National Cancer Data Base (1985Y2000). Univariate and multivariable methods were used to assess factors associated with survival. Concordance was calculated to assess agreement between American Joint Committee on Cancer stage and actual outcome. RESULTS: Nineteen thousand one hundred ninety-nine patients with anal carcinoma were identified (Stage I, 25.3 percent; Stage II, 51.8 percent; Stage III, 17.1 percent; Stage IV, 5.7 percent). Overall five-year survival was 58.0 percent. The American Joint Committee on Cancer (6th edition) staging system provided good survival discrimination by stage: I, 69.5 percent; II, 59.0 percent; III, 40.6 percent; and IV, 18.7 percent (concordance index, 0.663). On multivariable analysis, patients with anal carcinoma had a higher risk of death if they were male, ≥65 years old, black, living in lower median incomes areas, and had more advanced T stage tumors, nodal or distant metastases, or poorly differentiated cancers (P < 0.0001). There was not a significant difference in survival by hospital type or year of diagnosis. CONCLUSION: Although tumor characteristics and staging affect prognosis, patient factors, such as gender, race, and socioeconomic status, are also important prognostic factors for squamous-cell carcinoma of the anal canal.",
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Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal : Analysis of patients from the national cancer data base. / Bilimoria, Karl Y; Bentrem, David Jason; Rock, Colin E.; Stewart, Andrew K.; Ko, Clifford Y.; Halverson, Amy L.

In: Diseases of the Colon and Rectum, Vol. 52, No. 4, 01.04.2009, p. 624-631.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal

T2 - Analysis of patients from the national cancer data base

AU - Bilimoria, Karl Y

AU - Bentrem, David Jason

AU - Rock, Colin E.

AU - Stewart, Andrew K.

AU - Ko, Clifford Y.

AU - Halverson, Amy L

PY - 2009/4/1

Y1 - 2009/4/1

N2 - PURPOSE: The objective of this study was to assess survival and prognostic factors for anal carcinoma in the population. METHODS: Patients with squamous-cell carcinoma of the anal canal were identified from the National Cancer Data Base (1985Y2000). Univariate and multivariable methods were used to assess factors associated with survival. Concordance was calculated to assess agreement between American Joint Committee on Cancer stage and actual outcome. RESULTS: Nineteen thousand one hundred ninety-nine patients with anal carcinoma were identified (Stage I, 25.3 percent; Stage II, 51.8 percent; Stage III, 17.1 percent; Stage IV, 5.7 percent). Overall five-year survival was 58.0 percent. The American Joint Committee on Cancer (6th edition) staging system provided good survival discrimination by stage: I, 69.5 percent; II, 59.0 percent; III, 40.6 percent; and IV, 18.7 percent (concordance index, 0.663). On multivariable analysis, patients with anal carcinoma had a higher risk of death if they were male, ≥65 years old, black, living in lower median incomes areas, and had more advanced T stage tumors, nodal or distant metastases, or poorly differentiated cancers (P < 0.0001). There was not a significant difference in survival by hospital type or year of diagnosis. CONCLUSION: Although tumor characteristics and staging affect prognosis, patient factors, such as gender, race, and socioeconomic status, are also important prognostic factors for squamous-cell carcinoma of the anal canal.

AB - PURPOSE: The objective of this study was to assess survival and prognostic factors for anal carcinoma in the population. METHODS: Patients with squamous-cell carcinoma of the anal canal were identified from the National Cancer Data Base (1985Y2000). Univariate and multivariable methods were used to assess factors associated with survival. Concordance was calculated to assess agreement between American Joint Committee on Cancer stage and actual outcome. RESULTS: Nineteen thousand one hundred ninety-nine patients with anal carcinoma were identified (Stage I, 25.3 percent; Stage II, 51.8 percent; Stage III, 17.1 percent; Stage IV, 5.7 percent). Overall five-year survival was 58.0 percent. The American Joint Committee on Cancer (6th edition) staging system provided good survival discrimination by stage: I, 69.5 percent; II, 59.0 percent; III, 40.6 percent; and IV, 18.7 percent (concordance index, 0.663). On multivariable analysis, patients with anal carcinoma had a higher risk of death if they were male, ≥65 years old, black, living in lower median incomes areas, and had more advanced T stage tumors, nodal or distant metastases, or poorly differentiated cancers (P < 0.0001). There was not a significant difference in survival by hospital type or year of diagnosis. CONCLUSION: Although tumor characteristics and staging affect prognosis, patient factors, such as gender, race, and socioeconomic status, are also important prognostic factors for squamous-cell carcinoma of the anal canal.

KW - Anal carcinoma

KW - Chemotherapy

KW - Disparities

KW - National Cancer Data Base

KW - Radiation

KW - Staging

KW - Surgery

KW - Treatment

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