Journal article
The impact of location on the prognosis of squamous cell carcinomas of the anorectal region
The Journal of surgical research, Vol.231, pp.173-178
11/2018
DOI: 10.1016/j.jss.2018.05.050
PMID: 30278926
Abstract
Because anal and rectal squamous cell carcinomas (R-SCCs and A-SCCs) share a common histology and an excellent response to chemoradiation, we hypothesized that R-SCC and A-SCC may represent a similar biological entity, and location would not affect clinical presentation and prognosis.
Patients diagnosed with R-SCC (n = 2881) and A-SCC (n = 21,854) were identified in the Surveillance, Epidemiology, and End Results database (1998-2013). R-SCCs were staged based on American Joint Committee on Cancer classification for A-SCC, and impact of location was analyzed accordingly.
Compared to A-SCC, R-SCCs were more common in females (65% versus 48%, P < 0.001) and older patients (62 versus 56 yrs, P < 0.001). R-SCC presented with more advanced disease than A-SCC: mean size 4.2 versus 3.6 cm; T4 14% versus 5%; nodal involvement 20% versus 15%; and metastases 13% versus 6% (all P < 0.001). In multivariable analysis, R-SCCs and A-SCCs had similar disease-specific survival (DSS) for stages 0, I, and III; however, stage II R-SCC had significantly worse DSS than A-SCCs (P = 0.002). This was due to a greater proportion of T3 (>5 cm) R-SCC tumors (36% versus 27%, P < 0.001), which had a lower DSS than T2 (2-5 cm) tumors. Within T3 and T4 tumors, R-SCCs had lower DSS than A-SCCs.
R-SCC presented with higher stages than A-SCC, suggesting a delayed diagnosis. Larger R-SCC (T3-T4) had worse survival compared to T3-4 A-SCC, which may be due to a combination of more advanced disease within-stage as well as the use of less efficacious therapeutic regimens. Therefore, location may represent a significant prognostic factor for SCC of the anorectal region.
Details
- Title: Subtitle
- The impact of location on the prognosis of squamous cell carcinomas of the anorectal region
- Creators
- Paolo Goffredo - Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IowaTimothy J Robinson - Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FloridaJessica M Frakes - Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FloridaAnna C Beck - Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IowaPiyush Kalakoti - Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IowaImran Hassan - Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of surgical research, Vol.231, pp.173-178
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jss.2018.05.050
- PMID
- 30278926
- ISSN
- 0022-4804
- eISSN
- 1095-8673
- Language
- English
- Date published
- 11/2018
- Academic Unit
- Orthopedics and Rehabilitation; Surgery
- Record Identifier
- 9984051725402771
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