Clinical characteristics and prognosis of anal squamous cell carcinoma: a retrospective audit of 144 patients from 11 cancer hospitals in southern China

Abstract

Background: The incidence of anal squamous cell carcinoma (SCC) has been steadily growing globally in the past decade. Clinical data on anal SCC from China are rare. We conducted this study to describe the clinical and epidemiological characteristics of anal SCC in China and explore prognostic factors of outcomes among patients with anal SCC. Methods: We audited demographic characteristics, relevant symptoms, risk factors, treatment modalities and outcomes for patients diagnosed with anal SCC at 11 medical institutions in China between January 2007 and July 2018. Results: A total of 144 patients (109 females) were diagnosed with SCC during this period. Median age at initial diagnosis was 52.0 (interquartile range: 46.0-61.8) years. The most common symptoms were bleeding (n = 93, 64.6%), noticing a lump (n = 49, 34.0%), and pain (n = 47, 32.6%). The proportion of patients at the American Joint Committee on Cancer (AJCC) stages I-IV were 10 (6.9%), 22 (15.3%), 61 (42.4%) and 8 (5.6%), respectively, and AJCC stages in 43 (29.9%) patients were unknown. Thirty-six patients (25.0%) underwent abdominoperineal resection initially. Univariable analysis showed that T stage predicted recurrence-free survival (RFS) (Hazard ratio [HR] = 3.03, 95% Confidence interval [CI]: 1.10-8.37, p = 0.032), and age group (HR = 2.90, 95% CI: 1.12-7.49, p = 0.028), AJCC stage (HR = 4.56, 95% CI: 1.02-20.35, p = 0.046), and N stage (HR = 3.05, 95% CI: 1.07-8.74, p = 0.038) predicted overall survival (OS).

Comprehensive treatment experience of anal squamous cell carcinoma from a tertiary cancer center in South China

“…Unfortunately, the majority of patients in our study were not tested for HPV. The higher incidence in females than males in our study is consistent with previous studies 15,19 . The different incidence of ASCC in genders might be related to the inconsistency of HPV infection rate between men and women.…”

“…However, the 3‐year and 5‐year RFS were higher in our study, which were 90.8% and 86.30%, than the rates reported in previous researches 15,19 . This might be associated with the high percentage of patients who received surgery at initial treatment.…”

“…Similar results were reported in the RTOG 98–11 study with higher hematologic grade 3 or 4 toxicity in the FU/MMC arm compared with the FU/DDP arm (61.8% vs. 42%) 25 . Therefore, the mainstream chemotherapy regimens were PF and docetaxel plus cisplatin (TP) in China 15,26,27 . A long‐term result revealed that the actuarial 10‐year OS and DFS rates for the PF group were equivalent to the 5‐fluorouracil plus MMC (MF) group (OS 54% vs. 52%, p = 0.32, DFS 49% vs. 53%, p = 0.92) 28 .…”

“…Nevertheless, few studies focus on the treatment and prognosis of ASCC in China currently. Lu Y et al reported the clinical and epidemiological characteristics of 144 ASCC patients from multicenter in Southern China after 2007 as we mentioned before 15 . Li J et al evaluated the efficacy and safety of DDP/capecitabine (XP) with intensity‐modulated radiation therapy (IMRT) in 11 ASCC patients in Southwest China from January 2017 to June 2019 26 .…”

“…However, few works of literature focus on the treatment results of ASCC in China. Lu et al described the epidemiological characteristics of ASCC and prognostic factors of survival outcomes of 144 ASCC patients diagnosed between 2007 and 2018 from 11 cancer hospitals in southern China 15 . Results suggested that age >50 years, advanced AJCC stage, and lymph node positivity were correlated with poor survival of ASCC patients.…”