State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Werner, Ricardo Niklas; Gaskins, Matthew; Valle, Gabriela Avila; Budach, Volker; Koswig, Stephan; Mosthaf, Franz; Raab, Hans-Rudolf; Rödel, Claus; Nast, Alexander; Siegel, Robert; Aigner, Felix

doi:10.1016/j.radonc.2021.01.031

Cited by 6 publications

(3 citation statements)

References 81 publications

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“…For example, the RTOG 98 − 11 study showed that CRT improved OS and DFS, but the study did not include stage I patients [18]. Although some RCT studies achieved good results of CRT based on 5-Fu, these studies did not include T1/2N0M0 SCCA patients [11,[19][20][21]. Bosset et al found that the local recurrence rate of T1N0M0 SCCA patients receiving CRT was lower than that of patients treated with CT alone (RR = 0.35; 95% CI: 0.12-0.97; P < 0.05) [22].…”

Section: Discussionmentioning

confidence: 99%

“…This study found that LE has no disadvantage compared with CRT, and the advantages of LE include lower hospitalization costs and fewer complications among others. In the SCCA guideline, few or no T1/2N0M0 patients were included in studies of CRT for patients with SCCA [18][19][20][21]. Therefore, the treatment of early SCCA remains controversial.…”

Section: Discussionmentioning

confidence: 99%

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Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: A retrospective study combined with external validation

Liu

Zhao

2023

Preprint

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Background: Treatment options for T1/2N0M0 anal squamous cell carcinoma include chemotherapy, radiotherapy, chemoradiotherapy, and local excision, although the optimal treatment method has not been determined. Methods: The National Cancer Institute Surveillance, Epidemiology and Results database was used to search and screen 1,465 patients with cT1/2N0M0 anal squamous cell carcinoma who were clinically diagnosed between 2004 and 2016. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Cox proportional hazards regression analysis was performed to screen independent prognostic factors and build a nomogram survival prediction model. According to the risk score, patients were divided into low, medium, and high risk groups using X-tile software. Results: Age, sex, grade, size, and cT stage were identified as independent prognostic factors for cT1/2N0M0 anal squamous cell carcinoma and were included in the nomogram to construct a prediction model. The C-index of the model was 0.670 [95% confidence interval (CI), 0.693–0.756], which was higher than the C-index of T stage 0.565 (95% CI, 0.550–0.612). Low risk patients benefited from local resection, medium risk patients benefited from radiotherapy, and high risk patients benefited from radiotherapy or chemoradiotherapy. This was confirmed using external validation data from the center. Conclusion: The nomogram developed in this study effectively and comprehensively evaluated the prognosis of patients with cT1/2N0M0 squamous cell carcinoma of the anal canal. Local excision is recommended for low risk patients, radiotherapy for intermediate risk patients, and radiotherapy or chemoradiotherapy for high risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: A retrospective study combined with external validation

Liu

Zhao

2023

Preprint

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“…Small, localized anal margin tumours may be adequately treated with local excision (LE) alone without the need for CRT and its potential late toxicity risks [8]. However, there are few published trials and series which quantify the risk of local recurrence (LR) in patients treated by LE alone for anal margin tumours [9]. There are no data correlating LR risk with resection margins (RMs) to determine the minimal margin necessary to achieve local disease control.…”

Section: Introductionmentioning

confidence: 99%

Management of small (T1–T2) anal margin squamous cell carcinoma: clinical outcomes following local excision alone

et al. 2023

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Aim Squamous cell carcinomas of the anus are normally treated with synchronous chemoradiotherapy (CRT). Small, localized anal margin tumours may be adequately treated by local excision (LE) alone. This study aims to investigate the outcomes of patients with anal margin tumours treated with LE alone, reserving the use of CRT for salvage on local recurrence (LR). Methods Patients with small, localized (stage I/IIA) anal margin tumours treated by LE from October 1999 to September 2018 were identified. The effect of tumour size and resection margin on LR risk was analysed. Outcomes of overall survival and disease‐free survival were measured. Results Fifty‐five patients with anal margin tumours were identified. Overall 5‐year LR, overall survival and disease‐free survival rates were 8%, 86% and 82% respectively. Of the seven LRs, five were successfully salvaged with CRT with no further recurrence and two were not fit for CRT. Resection margins in non‐fragmented tumours and tumour size did not significantly influence LR risk. Conclusions Most small, localized anal margin tumours can be adequately treated by LE alone with low LR rates. Most patients who developed LR were salvaged using CRT, with no cancer‐related deaths reported.

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Anal Cancer

Mahmoodand,

Glynne‐Jones

2023

Cancer Consult

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State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Cited by 6 publications

References 81 publications

Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: A retrospective study combined with external validation

Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: A retrospective study combined with external validation

Management of small (T1–T2) anal margin squamous cell carcinoma: clinical outcomes following local excision alone

Anal Cancer

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