Treatment, outcome, and prognostic factors in non-metastatic anal cancer: The French nationwide cohort study FFCD-ANABASE - Université de Rennes Access content directly
Journal Articles Radiotherapy & Oncology Year : 2023

Treatment, outcome, and prognostic factors in non-metastatic anal cancer: The French nationwide cohort study FFCD-ANABASE

1 Inserm U1312 - BRIC - BoRdeaux Institute in onCology
2 CHU Bordeaux
3 ICM - Institut régional de Cancérologie de Montpellier
4 Centre Léon Bérard [Lyon]
5 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
6 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
7 CHU Tenon [AP-HP]
8 SU - Sorbonne Université
9 Clinique Tivoli Ducos [Bordeaux]
10 Centre hospitalier Saint-Joseph [Paris]
11 Centre Azuréen de Cancérologie [Mougins, France]
12 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
13 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
14 CHD Vendée - Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon
15 Institut Daniel Hollard [Grenoble]
16 Centre de radiothérapie et d'oncologie médicale privée (Béziers)
17 ICSC - Institut Curie - Saint Cloud
18 Clinique Mutualiste de l'Estuaire (Saint Nazaire)
19 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
20 OSS - Oncogenesis, Stress, Signaling
21 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
22 Polyclinique de Limoges - site François Chénieux [Limoges]
23 CHU Amiens-Picardie
24 UCBL - Université Claude Bernard Lyon 1
25 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
26 EMily (UMR_S_1160 / U1160) - Ecotaxie, microenvironnement et développement lymphocytaire
27 AP-HP - Hopital Saint-Louis [AP-HP]
Anne Larrouy
  • Function : Author

Abstract

Introduction: International guidelines regarding the treatment of squamous cell carcinoma of the anus (SCCA) recommend intensity-modulated radiotherapy (IMRT) combined with mitomycin-based chemotherapy (CT). The French FFCD-ANABASE cohort aimed at evaluating clinical practices, treatment, and outcomes of SCCA patients. Methods: This prospective multicentric observational cohort included all non-metastatic SCCA patients treated in 60 French centers from January 2015 to April 2020. Patients and treatment characteristics, colostomy-free survival (CFS), disease-free survival (DFS), overall survival (OS), and prognostic factors were analyzed. Results: Among 1015 patients (male: 24.4 %; female: 75.6 %; median age: 65 years), 43.3 %presented with early-stage(T1-2, N0) and 56.7 % with locally advanced stage (T3-4 or N + ) tumors. IMRT was used for 815 patients (80.3 %) and a concurrent CT was administered in 781 patients, consisting of mitomycin-based CT for 80 %. The median follow-up was 35.5 months. DFS, CFS, and OS at 3 years were 84.3 %, 85.6 %, and 91.7 % respectively in the early-stage group compared to 64.4 %, 66.9 %, and 78.2 % in the locally-advanced group (p < 0.001). In multivariate analyses, male gender, locally-advanced stage, and ECOG PS ≥ 1 were associated with poorer DFS, CFS, and OS. IMRT was significantly associated with a better CFS in the whole cohort and almost reached significance in the locally-advanced group. Conclusion: Treatment of SCCA patients showed good respect for current guidelines. Significant differences in outcomes advocate for personalized strategies by either de-escalation for early-stage tumors or treatment intensification for locally-advanced tumors.

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Cancer
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hal-04016479 , version 1 (29-03-2023)

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Attribution - NonCommercial

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Véronique Vendrely, Claire Lemanski, Pascal Pommier, Karine Le Malicot, Angélique Saint, et al.. Treatment, outcome, and prognostic factors in non-metastatic anal cancer: The French nationwide cohort study FFCD-ANABASE. Radiotherapy & Oncology, 2023, 183, pp.109542. ⟨10.1016/j.radonc.2023.109542⟩. ⟨hal-04016479⟩
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