Tumors larger than 5 cm, positive nodal status indicated poorer DFS, OS in anal carcinoma

Ajani JA. Cancer. 2010;doi:10.1002/cncr.25188.

Patients with anal cancer tumors larger than 5 cm and those with clinically positive nodes had lower DFS and OS rates compared with patients with smaller tumors, according to an analysis of the prospective database from the Intergroup RTOG 98-11 trial.

Researchers assessed 644 patients with histologically documented squamous, basaloid or cloacogenic carcinoma of the anal canal. One hundred seventy-two patients had tumors larger than 5 cm, and 167 patients had positive nodal status.

Multivariate analysis showed that the presence of tumors larger than 5 cm resulted in poorer 5-year DFS (HR=1.5; 95% CI, 1.14-1.97) and 5-year OS (HR=1.62; 95% CI, 1.12, 2.33) compared with patients whose tumors were between 2 cm and 5 cm in diameter.

Additionally, positive clinical nodal status was also associated with poorer 5-year DFS and OS (HR=2.66; 95% CI, 2.04-3.46).

Researchers then evaluated outcome by combined tumor diameter and nodal designation. Patients with tumors 5 cm or less in diameter and negative nodal status had the best outcomes for both DFS and OS. Five-year DFS was 66% for those patients, and 5-year OS was 80%.

As expected, patients with tumors larger than 5 cm and positive nodal status (n=60) had the worst prognosis. Three-year DFS in that group was 30%, and 4-year OS was 48%.

Overall, women had superior DFS (HR=1.38; 95% CI, 1.05-1.81) and OS (HR=1.57; 95% CI, 1.09-2.27). Researchers said male sex was associated with poorer DFS (P=.02) and OS (P=.016).

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