Abstract 429P
Background
Anal squamous cell carcinoma (ASCC) is rare and 2/3 of patients (pts) are >65 years (y) at diagnosis. Standard of care for localized stages is chemoradiotherapy (CRT) but data about elderly are scarce in the literature. We aimed to describe characteristics, therapeutic management and outcomes of elderly pts and compare them to those of younger pts. We also determined prognostic factors in elderly with ASCC.
Methods
All consecutive pts treated between 2015/01 and 2020/04 for a localized ASCC from the French multicenter ANABASE cohort were included. Two groups were defined according to age: elderly (≥75 y) and non-elderly (<75 y).
Results
Among 1378 pts included, 1015 were treated by radiotherapy or CRT: 202 (19.9%) and 813 (80.1%) in the elderly and non-elderly groups, respectively. In the elderly group, median age was 79 y [IQR: 77-84], the proportion of women was more important (p=0.0145) while there were less performance status (PS) 0-1 (p<0.001), smokers (p<0.001) and HIV-infected (p<0.001) pts than in the non-elderly group. Other baseline and tumoral characteristics were similar. Inguinal irradiation and concomitant chemotherapy were also less frequently performed (p=0.04 and p<0.001). Median follow-up was 35.5 months. In the elderly group, 3-year overall survival (OS), recurrence-free survival (RFS) and colostomy-free survival (CFS) were 82.9% (75.6-88.2), 72.4% (64.7-78.8) and 78.0% (70.5-83.9), respectively. Complete response rate at 4-6 months of treatment was 70.3%. There was no significant difference for all outcomes and in toxicity patterns between groups. In multivariate analyses for the elderly group, PS≥2 and locally advanced (T3-T4 or N+) tumors were associated with poor OS (HR=3.4 [1.4;8.3] and HR=2.80 [1.2;7.1]), RFS (HR=2.4 [1.2;4.9] and HR=3.1 [1.5;6.4]) and CFS (HR=3.8 [1.8;8.1] and HR=3.0 [1.4;6.7]), and treatment interruption was associated with poor RFS (HR=1.9 [1.1;3.5]).
Conclusions
In ANABASE cohort, age does not influence tumor and tolerance outcomes of localized ASCC. The optimal curative treatment should be offered to elderly pts after oncogeriatric assessment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Fédération Francophone de Cancérologie Digestive.
Funding
Fédération Fran.
Disclosure
All authors have declared no conflicts of interest.