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 J.
AU - Rock, Colin E.
AU - Stewart, Andrew K.
AU - Ko, Clifford Y.
AU - Halverson, Amy
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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U2 - 10.1007/DCR.0b013e31819eb7f0
DO - 10.1007/DCR.0b013e31819eb7f0
M3 - Article
C2 - 19404066
AN - SCOPUS:66849108902
SN - 0012-3706
VL - 52
SP - 624
EP - 631
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
IS - 4
ER -
