Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11)

Jaffer A. Ajani, Kathryn A. Winter, Leonard L. Gunderson, John Pedersen, Al B Benson III, Charles R. Thomas, Robert J. Mayer, Michael G. Haddock, Tyvin A. Rich, Christopher G. Willett

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30% at 3 years compared with 74% for the best group; <5 cm primary and N0) and OS (only 48% at 4 years compared with 81% for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.

Original languageEnglish (US)
Pages (from-to)4007-4013
Number of pages7
JournalCancer
Volume116
Issue number17
DOIs
StatePublished - Sep 1 2010

Fingerprint

Anus Neoplasms
Disease-Free Survival
Databases
Survival
Neoplasms
Statistical Factor Analysis
Multivariate Analysis

Keywords

  • Anal cancer
  • Clinical biology
  • Prognostic factors
  • Prospective database
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ajani, J. A., Winter, K. A., Gunderson, L. L., Pedersen, J., Benson III, A. B., Thomas, C. R., ... Willett, C. G. (2010). Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11). Cancer, 116(17), 4007-4013. https://doi.org/10.1002/cncr.25188
Ajani, Jaffer A. ; Winter, Kathryn A. ; Gunderson, Leonard L. ; Pedersen, John ; Benson III, Al B ; Thomas, Charles R. ; Mayer, Robert J. ; Haddock, Michael G. ; Rich, Tyvin A. ; Willett, Christopher G. / Prognostic factors derived from a prospective database dictate clinical biology of anal cancer : The intergroup trial (RTOG 98-11). In: Cancer. 2010 ; Vol. 116, No. 17. pp. 4007-4013.
@article{612b2f6a82f0429e85cb99618c26afc6,
title = "Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11)",
abstract = "BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30{\%} at 3 years compared with 74{\%} for the best group; <5 cm primary and N0) and OS (only 48{\%} at 4 years compared with 81{\%} for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.",
keywords = "Anal cancer, Clinical biology, Prognostic factors, Prospective database, Survival",
author = "Ajani, {Jaffer A.} and Winter, {Kathryn A.} and Gunderson, {Leonard L.} and John Pedersen and {Benson III}, {Al B} and Thomas, {Charles R.} and Mayer, {Robert J.} and Haddock, {Michael G.} and Rich, {Tyvin A.} and Willett, {Christopher G.}",
year = "2010",
month = "9",
day = "1",
doi = "10.1002/cncr.25188",
language = "English (US)",
volume = "116",
pages = "4007--4013",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "17",

}

Ajani, JA, Winter, KA, Gunderson, LL, Pedersen, J, Benson III, AB, Thomas, CR, Mayer, RJ, Haddock, MG, Rich, TA & Willett, CG 2010, 'Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11)', Cancer, vol. 116, no. 17, pp. 4007-4013. https://doi.org/10.1002/cncr.25188

Prognostic factors derived from a prospective database dictate clinical biology of anal cancer : The intergroup trial (RTOG 98-11). / Ajani, Jaffer A.; Winter, Kathryn A.; Gunderson, Leonard L.; Pedersen, John; Benson III, Al B; Thomas, Charles R.; Mayer, Robert J.; Haddock, Michael G.; Rich, Tyvin A.; Willett, Christopher G.

In: Cancer, Vol. 116, No. 17, 01.09.2010, p. 4007-4013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic factors derived from a prospective database dictate clinical biology of anal cancer

T2 - The intergroup trial (RTOG 98-11)

AU - Ajani, Jaffer A.

AU - Winter, Kathryn A.

AU - Gunderson, Leonard L.

AU - Pedersen, John

AU - Benson III, Al B

AU - Thomas, Charles R.

AU - Mayer, Robert J.

AU - Haddock, Michael G.

AU - Rich, Tyvin A.

AU - Willett, Christopher G.

PY - 2010/9/1

Y1 - 2010/9/1

N2 - BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30% at 3 years compared with 74% for the best group; <5 cm primary and N0) and OS (only 48% at 4 years compared with 81% for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.

AB - BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30% at 3 years compared with 74% for the best group; <5 cm primary and N0) and OS (only 48% at 4 years compared with 81% for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.

KW - Anal cancer

KW - Clinical biology

KW - Prognostic factors

KW - Prospective database

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=77956870017&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956870017&partnerID=8YFLogxK

U2 - 10.1002/cncr.25188

DO - 10.1002/cncr.25188

M3 - Article

C2 - 20564111

AN - SCOPUS:77956870017

VL - 116

SP - 4007

EP - 4013

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 17

ER -