Results of age-dependent anal canal cancer treatment: a single centre retrospective study.

BACKGROUND: Information concerning management of anal canal cancer among the elderly is scarce and much less abundant than for younger subjects. POPULATION AND METHODS: We retrospectively analysed 115 patients treated for anal epidermoid cancer between 2000 and 2010. The population was divided according to age (<70 years and ≥70 years). RESULTS: Of the 115 patients, 81 (70.4%) were <70 years old and 34 were ≥70 years (29.6%). Tumour characteristics were identical between the two groups and median follow-up was 62 months. Elderly patients had a less favourable performance status (p=0.001) and fewer had received radiochemotherapy (61.8% vs 82.5%, p=0.004). Treatment-related grade 3 and 4 hematologic toxicity was observed more often among elderly subjects. The results at 5 years were less favourable for overall, disease-specific, and disease-free survival (respectively p=0.002, p=0.001, and p=0.001). For patients treated with a curative intent, at 5 years there was no difference between the two groups in terms of overall survival (p=0.2). However, there was a statistically significant difference in favour of the younger group for disease-free survival and metastasis-free survival. CONCLUSION: If radiochemotherapy can be delivered to elderly subjects with a good general status, the effects appear less favourable than in younger patients.