What is the optimal treatment for T1N0 anal squamous cell carcinoma? Analysis of current practices in the prospective French FFCD ANABASE cohort.
Dig Liver Dis
; 53(6): 776-784, 2021 06.
Article
en En
| MEDLINE
| ID: mdl-33867291
ABSTRACT
INTRODUCTION:
for localized T1N0 squamous cell carcinoma of the anus (SCCA) standard radiotherapy (RT) may result in overtreatment and alternative strategies are debated.METHODS:
T1N0M0 SCCA treated between 2015 and 2020 by local excision (LE) or RT were analyzed from the French prospective FFCD ANABASE cohort. Treatment strategies, recurrence-free and colostomy-free survivals (RFS, CFS) and prognostic factors were reported.RESULTS:
among 1135 SCCA patients, 99 T1N0M0 were treated by LE(nâ¯=â¯17,17.2%), or RT (nâ¯=â¯82,82.8%) including RT alone (nâ¯=â¯65,79.2%) or chemo-RT (nâ¯=â¯17, 20.7%). Median follow-up was 27.2 months [0.03-54.44]. Median tumor size were 11.4â¯mm [0.9-20] and 15.3â¯mm [2-20] in the LE and RT groups respectively. Mean RT tumor dose was 59.4â¯Gy [18-69.4â¯Gy]. One patient in LE group and 9 in RT group had a pelvic recurrence, either local (60%), nodal (10%) or both (30%). RFS and CFS at 24 months were 92.2%[95%CI,83.4-96.4] and 94.6%[95%CI,86.1-98.0], at 36 months 88.1%[95%CI,77.1-94.2] and 88.5%[95%CI,77.0-94.5], in LE and RT group respectively, without any significative difference (HRâ¯=â¯0.57;[95%CI,0.07-4.45];pâ¯=â¯0.60). By univariate analysis, male gender was the only prognostic factor(HR = 5.57;95%CI, 1.76-17.63; pâ¯=â¯0.004).CONCLUSION:
this cohort confirms the heterogeneity of T1N0M0 SCCA management, questioning the place of RT alone, reduced dose or RT volume, and the safety of LE.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Canal Anal
/
Neoplasias del Ano
/
Radioterapia
/
Carcinoma de Células Escamosas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Dig Liver Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Francia