P-152 - Impact of anemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Supportive Measures
Anal Cancer
Presenter I. Oblak
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors I. Oblak, F. Anderluh, V. Velenik, J. But-Hadzic, A. Secerov-Ermenc, A. Jeromen
  • Institute of Oncology, Ljubljana/SI

Abstract

Introduction

Radiochemotherapy is the basic treatment for patients with squamous cell carcinoma of the anal canal. Anemia is reported to have adverse effects on treatment outcome.

Methods

In the period from January 2003 to January 2013, 97 consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment hemoglobin (Hb) concentrations was studied.

Results

Ninety-two percent of patients completed treatment according to the protocol. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 70%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb >120 g/L had significantly better survival than patients with Hb ≤120 g/L. Patients with mean on-treatment Hb >120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (>120 g/L vs. ≤120 g/L) for overall survival (HR = 0.407, 95% CI = 0.181–0.920, p = 0.031) and stage (I & II vs. III) for disease specific (HR = 4.038, 95% CI = 1.582–10.303, p = 0.003) and overall survival (HR = 2.350, 95% CI = 1.226–4.502, p = 0.010).

Conclusion

The pre-treatment, mean on-treatment and end-of-treatment Hb concentration >120 g/L carried better prognosis for patients with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb >120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.