Epidemiological and prognostic single center study of anal carcinoma

Abstract

Background Anorectal carcinoma includes the anal margin, the anal canal, and the lower rectum. The incidences of anal tumors represent 1.4 % of all gastrointestinal tumors. Patients and methods Our study is retrospective and was conducted at Baghdad Medical City. Patient’s data were collected from the medical records through a predesigned sheet that included the following information: demographic data, medical history, past-history, presenting symptoms, pathological data, and treatment details. Results The median age was 49 years. As regard tumor extension, 85.71 % of patients had anal disease, while anorectal cancer was encountered in 14.28 % of cases only. Male to female ratio was 1:3. Most of cases were SCC 78.57 %. Only 11 patients (39.28 %) were diagnosed as Stage I, whereas 12 patients (42.85 %) had Stage II-III disease. Moderate differentiated tumors are the most common. The tumor mass located between 5–10cm das a distance from anal verge in 12 (42.85 %) of patients. We found 6 (21.42 %) patients with positive virology tests with no specificity detected. APR was the mainstay for treatment of stage I disease. Neoadjuvant treatment followed by TME resection was the treatment found in locally advanced tumors. The mean Overall Survival (OS) for patients received neoadjuvant CRT in the study was 43.5 months, while, the mean OS was 45.73 months in the adjuvant setting. Univariate analysis for OS according to prognostic factors revealed that sites of cancer, grades and histopathology were significant independent prognostic factors for OS in this study. The anal canal tumor was associated with shorter OS (33.25) months in comparison to the anorectal cancer (OS = 47.22 months). Based on tumor grade, well and moderate differentiation have better OS (60.21 months) while, poorly grade was associated with shorter OS (43.07 months). On the concern of SCC, it was associated with shorter OS (37 months) in comparison to higher survival in patients with adenocarcinoma (46.13 months). Conclusion Anal canal cancer has poorer prognosis than anorectal. The early-stage has a better OS that needs more effort for early diagnosis and treatment.

Volumetric Modulated Arc Therapy Improves Outcomes in Definitive Radiochemotherapy for Anal Cancer Whilst Reducing Acute Toxicities and Increasing Treatment Compliance

“…Moreover, VMAT-treated patients experienced better outcomes (CSS and DC) than 3DCRT-treated patients. Remarkably, we observed this effect in spite of the more aggressive tumors (G3 tumors, 29.0% vs. 13.8%) seen in the VMAT group [47]. During the last few decades, several studies have highlighted the negative prognostic impact of decreased treatment compliance on patient survival in anal cancer [4,10,44].…”

Proteinemia as a Prognostic Factor in Colorectal Cancers beyond Surgery and Chemotherapy

“…17 All researchers in Iraq support these findings. [2][3][4][14][15][16]18,24 However, these findings are different from the Surveillance, Epidemiology, and End Results Program (SEER) data that reported the localized site of CRC was (47%), regional (36.5%), metastatic (16.5%) of CRC cases. This can be due to different sample sizes, early diagnosis and treatment provided by screening programs, good health education, and awareness in the US and other developed countries.…”

“…1 Besides, 551,269, 310,394 and 19,129 cases of colon, rectum, and anus cancer deaths occurred in the same year. [1][2][3][4] As a result, these cancers ranked in the third level of cancer incidence, and in the second level of cancer mortality. 1 The incidence rates are higher, which is about 3-fold in developed countries in comparison with developing countries.…”

“…11 The primary potentially curative therapy for CRC is surgery, in addition to chemotherapy and radiotherapy in neoadjuvant and adjuvant forms. [2][3][4]11,12 The present study tries to assess protein concentration as a nutrient and prognostic factor in CRC patients who underwent surgery and chemotherapy.…”