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. 2024 Sep 2;31(9):5151-5163.
doi: 10.3390/curroncol31090381.

Factors Influencing Outcomes and Survival in Anal Cancer

Hugo C Temperley  1   2   3 , Benjamin M Mac Curtain  2 , Niall J O'Sullivan  1   2 , Cormac Mulhall  2 , Tatiana S Temperley  2 , Brian J Mehigan  2 , John O Larkin  2 , Paul H McCormick  2 , Colm Kerr  4 , David Gallagher  5   6 , Colm Bergin  4 , Charles Gillham  7 , Michael E Kelly  2   3
Affiliations

Factors Influencing Outcomes and Survival in Anal Cancer

Hugo C Temperley et al. Curr Oncol. .

Abstract

Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study.

Methods: We reviewed the management and outcomes of anal cancer cases over a seven-year period, inclusive (2016-2023). The primary objectives were to assess the demographic characteristics, clinical presentation, and outcomes of all anal cancer patients within our institution. Kaplan-Meier survival analysis was used to estimate survival differences between cohorts, with statistical significance determined using log-rank testing. Cox proportional hazards regression was utilised to identify prognostic factors. Cox regression hazard ratios were reported along with confidence intervals and p-values.

Results: The median follow-up time for the study was 29.8 months. Seventy-five patients with anal cancer were included in this study, with 88% (66/75) being squamous cell carcinoma (SCC) and the majority having regional disease (82.7% (62/75)). The median age at diagnosis was 63.4 years (36-94). There was a female preponderance (57.3% (43/75)). In total, 84% (63/75) underwent definitive chemoradiation (dCRT), with 7/63 (11.1%) requiring a salvage abdomino-perineal resection (APR) for residual or recurrent disease. Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.13-12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13-10.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.11-22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28-26.42, * p = 0.02).

Conclusion: Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy.

Keywords: anal cancer; oncological outcomes; recurrence; salvage surgery; survival; treatment response.

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Conflict of interest statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for nodal status. (B) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for poor histological differentiation. (C) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for T4 tumour stage. (D) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for metastasis at diagnosis.
Figure 1
Figure 1
(A) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for nodal status. (B) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for poor histological differentiation. (C) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for T4 tumour stage. (D) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for metastasis at diagnosis.
Figure 1
Figure 1
(A) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for nodal status. (B) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for poor histological differentiation. (C) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for T4 tumour stage. (D) Kaplan–Meier Survival Curves (Log-Rank Test Results (p < 0.05)) for metastasis at diagnosis.
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