Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
SURVIVAL AND PROGNOSTIC FACTORS OF ANAL CANCER: A STUDY BASED ON DATA FROM THE HOSPITAL-BASED CANCER REGISTRY OF A HIGH-COMPLEXITY ONCOLOGY CARE CENTER.
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Paixão Wallace Henrique Pinho da, Mendes Gelcio Luiz Quintella, Silva Débora Santos da, Souza Rosyane Garcês Moreira Lima de, Araujo Rodrigo Otavio de Castro, Meira Karina Cardoso, Jomar Rafael Tavares
Аннотация
BACKGROUND: Anal cancer is a relatively rare disease, and there is a lack of survival data from low- and middle-income countries.
AIMS: The aim of this study was to investigate the survival rates and prognostic factors of anal cancer cases treated at a High-Complexity Oncology Care Center in Rio de Janeiro, Brazil.
METHODS: A retrospective cohort study was conducted involving 665 cases of squamous cell carcinoma of the anus/anal canal treated from 2000 to 2016. To estimate the 5-year overall survival probability and survival according to selected variables, the Kaplan-Meier method and the log-rank test were applied. To identify factors associated with survival, the Cox proportional hazards model, stratified by staging, was used to estimate hazard ratios (HR). Ninety-five percent confidence intervals (95%CI) were also calculated.
RESULTS: The overall survival probability was 62.20% (95%CI 57.90-66.20). Higher survival rates were observed in female cases, those with non-advanced staging, and those treated with chemoradiotherapy (p<0.001). Among cases with advanced staging, being female was a protective factor against death (HR=0.52; 95%CI 0.28-0.93). Compared to chemoradiotherapy, at least one type of treatment was identified as a risk factor: chemoradiotherapy + surgery among cases with non-advanced staging (HR=22.65; 95%CI 5.65-90.81), radiotherapy among cases with advanced staging (HR=2.71; 95%CI 1.39-5.30), and among cases with unknown staging, no treatment (HR=3.36; 95%CI 1.73-6.50), radiotherapy (HR=2.38; 95%CI 1.46-3.88), and radiotherapy + surgery (HR=3.99; 95%CI 1.20-13.27).
CONCLUSIONS: The findings support the superiority of chemoradiotherapy over other therapeutic modalities for anal cancer, resulting in increased survival and a better prognosis.
AIMS: The aim of this study was to investigate the survival rates and prognostic factors of anal cancer cases treated at a High-Complexity Oncology Care Center in Rio de Janeiro, Brazil.
METHODS: A retrospective cohort study was conducted involving 665 cases of squamous cell carcinoma of the anus/anal canal treated from 2000 to 2016. To estimate the 5-year overall survival probability and survival according to selected variables, the Kaplan-Meier method and the log-rank test were applied. To identify factors associated with survival, the Cox proportional hazards model, stratified by staging, was used to estimate hazard ratios (HR). Ninety-five percent confidence intervals (95%CI) were also calculated.
RESULTS: The overall survival probability was 62.20% (95%CI 57.90-66.20). Higher survival rates were observed in female cases, those with non-advanced staging, and those treated with chemoradiotherapy (p<0.001). Among cases with advanced staging, being female was a protective factor against death (HR=0.52; 95%CI 0.28-0.93). Compared to chemoradiotherapy, at least one type of treatment was identified as a risk factor: chemoradiotherapy + surgery among cases with non-advanced staging (HR=22.65; 95%CI 5.65-90.81), radiotherapy among cases with advanced staging (HR=2.71; 95%CI 1.39-5.30), and among cases with unknown staging, no treatment (HR=3.36; 95%CI 1.73-6.50), radiotherapy (HR=2.38; 95%CI 1.46-3.88), and radiotherapy + surgery (HR=3.99; 95%CI 1.20-13.27).
CONCLUSIONS: The findings support the superiority of chemoradiotherapy over other therapeutic modalities for anal cancer, resulting in increased survival and a better prognosis.