A Population-Based and Propensity Score-Matched Investigation of the Occurrence, Management, and Prognosis of Anal Mucinous Adenocarcinoma Patients

Oncol Res Treat. 2024;47(10):474-483. doi: 10.1159/000539930. Epub 2024 Jun 27.

Abstract

Introduction: Anal mucinous adenocarcinoma (AMAC) is an extremely rare form of anal cancer. Our objective was to examine the incidence, management, and prognostic factors of AMAC.

Methods: We analyzed age-adjusted incidence (AAI) rates over time and compared the prognosis of AMAC with anal squamous cell carcinoma (ASCC) and adenocarcinoma (AAC) using propensity score matching and Kaplan-Meier analysis. Patients were classified based on summary stage and treatments to determine cancer-specific survival.

Results: AAI of AMAC fluctuated within a narrow range (0.082-0.237 per million person-years) from 2000 to 2018. AMAC had a slight non-significant trend of worse prognosis than ASCC (p = 0.348) and a better prognosis than AAC (p < 0.01). Females made up a larger proportion of patients diagnosed with the distant disease (p < 0.05) and unmarried (p < 0.05) and somewhat less probably to need surgical removal (p < 0.01) and radiotherapy (p < 0.01). Elderly patients have lower rates of survival (p < 0.05). Localized stage was associated with better prognosis (p < 0.05). Surgery was associated with a tendency toward better survival (p = 0.095).

Conclusions: AMAC exhibits a low incidence yet favorable prognosis compared to typical AAC and slightly worse compared to ASCC. Elderly age is associated with poorer prognosis, while localized stage indicates better prognosis. Surgery demonstrates a trend toward improved survival.

Keywords: Anal adenocarcinoma; Anal mucinous adenocarcinoma; Anal squamous cell carcinoma; Incidence; Prognosis; Radiation therapy; Surgery.

MeSH terms

  • Adenocarcinoma, Mucinous* / epidemiology
  • Adenocarcinoma, Mucinous* / mortality
  • Adenocarcinoma, Mucinous* / pathology
  • Adenocarcinoma, Mucinous* / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Anus Neoplasms* / epidemiology
  • Anus Neoplasms* / mortality
  • Anus Neoplasms* / pathology
  • Anus Neoplasms* / therapy
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Propensity Score*
  • SEER Program
  • Survival Rate

Grants and funding

This study was partially supported by the National Nature Science Foundation of China (82171890), Key Research and Development Projects of Zhejiang Provincial Science and Technology Department (2021C03122), the Health Commission of Zhejiang Province (2020KY131), and a project supported by Scientific Research Fund of Zhejiang Provincial Education Department (Y202148354).