Abstract 8P
Background
Verrucous carcinoma (VC) is an extremely rare variant of squamous cell carcinoma. There are only 50 cases reported in the literature and limited to few case reports. It is slowly progressive, well-differentiated and grows as a cauliflower-like mass. So surgery is the most widely used treatment strategy. However, due to its scarcity, there are no available data about the other treatment modalities. So this study aims to evaluate different management approaches and the clinicopathological features of gastrointestinal VC for better understanding of this rare subtype.
Methods
We obtained the data from a national cancer database for patients diagnosed with gastrointestinal verrucous carcinoma from 2000-2020. We subdivided the patients according to their treatment strategy into three groups: surgery with no systemic therapy, medical therapy (chemotherapy/radiotherapy) and adjuvant chemo(radio)therapy following the surgery. We used SPSS version 23 for data analysis. Survival analysis was done using Kaplan-Meier and Log-Rank test.
Results
Out of 215 patients, 74.9% were males. The mean age was 54.9 (SD=15.6). The majority had anaorecatal VC (77.6%) and osoephageal VC (14.4%). VC had 3-year and 5-year relative survival of 80.2% and 74.0%. About 53% were treated surgically with no systemic therapy, 29.3% received adjuvant therapy and 8.8% were treated medically with 5-year relative survival of 81.9%, 73.9% and 51.8% respectively; P=0.03. Performing COX-regression model, annorectal VC was associated with significant improved survival (HR=0.79, P=0.007, 95%CI: 0.107-5.78) while age (HR=1.03, P>0.00, 95%CI: 1.016-1.05) and race (HR=1.054, P=0.025, 95%CI: 1.007- 1.104) were significantly associated with worst survival outcome.
Conclusions
Gastrointestinal VC has good survival outcome and more common in males. Surgery has improved survival outcome compared adjuvant therapy and has survival benefit about 30% compared to medical treatment. These results highlight surgical excision as the best strategy and encourage to avoid chemo(radio)therapy in VC management for better quality of life after VC management and less serious systemic side effects.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.