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

Dig Liver Dis. 2014 May;46(5):460-4. doi: 10.1016/j.dld.2014.01.004. Epub 2014 Feb 17.

Abstract

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.

Keywords: Anal canal cancer; Elderly; Radiochemotherapy; Radiotherapy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Anus Neoplasms / pathology
  • Anus Neoplasms / surgery
  • Anus Neoplasms / therapy*
  • Brachytherapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy / adverse effects
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Rate
  • Tumor Burden

Substances

  • Mitomycin
  • Cisplatin
  • Fluorouracil