Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review

Samuel, Robert; Lilley, J.; Henry, Ann; Sebag‐Montefiore, David; Gilbert, Alexandra; Appelt, Ane L

doi:10.1186/s12885-022-09729-4

Cited by 9 publications

(6 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Already-established prognostic factors for the outcomes in question have been identified through a systematic review of the literature [ 34 ]. Studies published after 2000 which reported on disease-related outcomes and examined prognostic factors in multivariable analysis for overall survival, locoregional control, and freedom from distant metastasis were reviewed.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of prognostic models for anal cancer outcomes using distributed learning: protocol for the international multi-centre atomCAT2 study

Lønne¹,

Choudhury²,

Berbée³

et al. 2022

Diagn Progn Res

Self Cite

View full text Add to dashboard Cite

Background Anal cancer is a rare cancer with rising incidence. Despite the relatively good outcomes conferred by state-of-the-art chemoradiotherapy, further improving disease control and reducing toxicity has proven challenging. Developing and validating prognostic models using routinely collected data may provide new insights for treatment development and selection. However, due to the rarity of the cancer, it can be difficult to obtain sufficient data, especially from single centres, to develop and validate robust models. Moreover, multi-centre model development is hampered by ethical barriers and data protection regulations that often limit accessibility to patient data. Distributed (or federated) learning allows models to be developed using data from multiple centres without any individual-level patient data leaving the originating centre, therefore preserving patient data privacy. This work builds on the proof-of-concept three-centre atomCAT1 study and describes the protocol for the multi-centre atomCAT2 study, which aims to develop and validate robust prognostic models for three clinically important outcomes in anal cancer following chemoradiotherapy. Methods This is a retrospective multi-centre cohort study, investigating overall survival, locoregional control and freedom from distant metastasis after primary chemoradiotherapy for anal squamous cell carcinoma. Patient data will be extracted and organised at each participating radiotherapy centre (n = 18). Candidate prognostic factors have been identified through literature review and expert opinion. Summary statistics will be calculated and exchanged between centres prior to modelling. The primary analysis will involve developing and validating Cox proportional hazards models across centres for each outcome through distributed learning. Outcomes at specific timepoints of interest and factor effect estimates will be reported, allowing for outcome prediction for future patients. Discussion The atomCAT2 study will analyse one of the largest available cross-institutional cohorts of patients with anal cancer treated with chemoradiotherapy. The analysis aims to provide information on current international clinical practice outcomes and may aid the personalisation and design of future anal cancer clinical trials through contributing to a better understanding of patient risk stratification.

show abstract

Section: Methodsmentioning

confidence: 99%

Development and validation of prognostic models for anal cancer outcomes using distributed learning: protocol for the international multi-centre atomCAT2 study

Lønne¹,

Choudhury²,

Berbée³

et al. 2022

Diagn Progn Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Studies about prognostic biomarkers in ASCC are scarce. T stage, N status, and gender have been associated with prognosis in ASCC 28 . HPV16 infection and several clinical factors as neutrophilia or anemia have also been reported as related to OS and/or DFS 14,29,30 .…”

Section: Discussionmentioning

confidence: 99%

“…T stage, N status, and gender have been associated with prognosis in ASCC. 28 HPV16 infection and several clinical factors as neutrophilia or anemia have also been reported as related to OS and/or DFS. 14,29,30 Regarding gene-based biomarkers, p53-positive tumors have a shorter DFS.…”

Section: Discussionmentioning

confidence: 99%

Utility ofCYP2D6copy number variants as prognostic biomarker in localized anal squamous cell carcinoma

Trilla-Fuertes

Gámez‐Pozo

Nogué

et al. 2023

Cancer

View full text Add to dashboard Cite

Background: Anal squamous cell carcinoma (ASCC) is an infrequent tumor whose treatment has not changed since the 1970s. The aim of this study is the identification of biomarkers allowing personalized treatments and improvement of therapeutic outcomes.Methods: Forty-six paraffin tumor samples from ASCC patients were analyzed by whole-exome sequencing. Copy number variants (CNVs) were identified and their relation to disease-free survival (DFS) was studied and validated in an independent retrospective cohort of 101 ASCC patients from the Multidisciplinary Spanish Digestive Cancer Group (GEMCAD). GEMCAD cohort proteomics allowed assessing the biological features of these tumors.Results: On the discovery cohort, the median age was 61 years old, 50% were males, stages I/II/III: 3 (7%)/16 (35%)/27 (58%), respectively, median DFS was 33 months, and overall survival was 45 months. Twenty-nine genes whose duplication was related to DFS were identified. The most representative was duplications of the CYP2D locus, including CYP2D6, CYP2D7P, and CYP2D8P genes. Patients with CYP2D6 CNV had worse DFS at 5 years than those with two CYP2D6 copiesThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

show abstract

“…Factors that are widely known to affect survival are tumor size, nodal metastasis and sex [5]. Additionally, as etiology of anal cancer is closely related with human papilloma virus (HPV) or human immunodeficiency virus (HIV) infection, immunologic factors such as p16 expression, leukocytopenia, neutropenia, and lymphocytosis have been related with improved survival [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Bulky Nodal Disease in Anal Cancer Management: A Multi Institutional Study

Chun,

Kim,

Jang

et al. 2024

Cancer Res Treat

View full text Add to dashboard Cite

This study aimed to assess the prognostic significance of bulky nodal involvement in patients with anal squamous cell carcinoma treated with definitive chemoradiotherapy. Materials and MethodsWe retrospectively analyzed medical records of patients diagnosed with anal squamous cell carcinoma who underwent definitive chemoradiotherapy at three medical centers between 2004 and 2021. Exclusion criteria included distant metastasis at diagnosis, 2D radiotherapy, and salvage treatment for local relapse. Bulky N+ was defined as nodes with a long diameter of 2 cm or greater. ResultsA total of 104 patients were included, comprising 51 with N0, 46 with non-bulky N+, and 7 with bulky N+. The median follow-up duration was 54.0 months (range, 6.4-162.2 months). Estimated 5-year progression-free survival (PFS), loco-regional recurrence-free survival (LRRFS), and overall survival (OS) rates for patients with bulky N+ were 42.9%, 42.9%, and 47.6%, respectively.Bulky N+ was significantly associated with inferior PFS, LRRFS and OS compared to patients without or with non-bulky N+, even after multivariate analysis. We proposed a new staging system incorporating bulky N+ as N2 stage, with estimated 5-year LRRFS, PFS, and OS rates of 81.1%, 80.6%, and 86.2% for stage I, 67.7%, 60.9%, and 93.3% for stage II, and 42.9%, 42.9%, and 47.6% for stage III disease, enhancing the predictability of prognosis. ConclusionPatients with bulky nodal disease treated with standard chemoradiotherapy experienced poor survival outcomes, indicating the potential necessity for further treatment intensification.

show abstract

Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review

Cited by 9 publications

References 54 publications

Development and validation of prognostic models for anal cancer outcomes using distributed learning: protocol for the international multi-centre atomCAT2 study

Development and validation of prognostic models for anal cancer outcomes using distributed learning: protocol for the international multi-centre atomCAT2 study

Utility ofCYP2D6copy number variants as prognostic biomarker in localized anal squamous cell carcinoma

Prognostic Significance of Bulky Nodal Disease in Anal Cancer Management: A Multi Institutional Study

Contact Info

Product

Resources

About