Abstract 517P
Background
At presentation most patients with squamous cell carcinoma of the anal canal (SCCA) have early stage disease. The optimal treatment is controversial, most often with surgery, radiotherapy and chemotherapy. The current study aimed to evaluate the outcomes, prognostic factors, and the complications among patients with early stage(T1-T2) SCCA.
Methods
A retrospective multicentre study of patients diagnosed with SCCA, T1N0M0 and T2N0M0, was performed. The primary endpoint was to analyse disease-free survival curves (DFS) among patients who received complete treatment (chemotherapy with two drugs plus radiotherapy) versus (vs) patients with non-complete treatment (surgery, radiotherapy or chemoradiotherapy with one drug) using Kaplan-Meier analysis and Log Rank test. Prognostic factors were assessed using univariate and multivariate cox analysis.
Results
From March 2006 to January 2020, 108 patients were included in the study: 34 (31.5%) had T1 disease and 74 (68.5%) T2 disease. Median age at diagnosis was 58.5 years; 84 (77.8%) patients were female and 24 (22.2%) male. Most patients, 74 (68.5%), received full treatment and 34 (31.5%) received non-complete treatment. Overall survival was 90% at 5 years and disease free survival (DFS) was 72% at 5 years for the total cohort. Comparing those who received full treatment (group 1) vs those who received non-complete treatment (group 2), colostomy rates were higher in the second group, 9 (26.5%) vs 7 (9.5%) (P= 0.021). The median DFS was 91 months (95% confidence interval [CI]: 69.7 – 112.2) in group 2 and was not reached in group 1 (P= 0,05). In Cox’s analysis of DF, group 2 had a worse outcome with Hazard ratio (HR) 2.3 (IC 95% 0.99 – 5.74) (P= 0.052).
Conclusions
According to these results and recent randomized trials, chemotherapy with two drugs and concomitant radiotherapy should be the standard treatment for SCCA, including for those patients with early stage disease.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
AC Camargo Cancer Center.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.