Comparative Survival of Patients with Anal Adenocarcinoma, Squamous Cell Carcinoma of the Anus, and Rectal Adenocarcinoma

Robert A. Franklin, Smith Giri, Poojitha Valasareddy, Lindsey T. Lands, Michael Martin

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background Anal adenocarcinoma (AA) represents 5% to 10% of anal cancer. Little is known about its natural history and prognosis. Using population-based data, we defined the outcomes of AA relative to other anorectal malignancies. Patients and Methods We analyzed the Surveillance, Epidemiology, and End Results 18 database to identify patients ≥ 18 years old with AA, squamous cell carcinoma of the anus (SCCA), and rectal adenocarcinoma (RA) diagnosed between 1990 and 2011. Median overall survival (OS), 1-year, 3-year, 5-year, and 10-year OS were computed using actuarial methods. The log rank test was used to estimate the difference between Kaplan-Meier survival curves. A Cox proportional hazard regression model was used to adjust the effects of other covariates on survival, including age, year diagnosed, sex, stage, surgery, and radiation. Results Of 57,369 cases, 0.8% (n = 462) were patients with AA, 87.8% (n = 50,382) were patients with RA, and 11.4% (n = 6525) were patients with SCCA. The median age for AA was 69 years (range, 20-96 years), 66 years (range, 18-103 years) for RA, and 66 years (range, 14-104 years) for SCCA. The median OS was significantly lower for AA (33 months), compared with SCCA (118 months) and RA (68 months) (P <.01). In multivariate analysis, AA had a worse prognosis compared with SCCA (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.59-0.75; P <.01) and RA (HR, 0.68; 95% CI, 0.61-0.77; P <.01), after adjusting for age, sex, race, stage, grade, radiation, and surgery. There was a strong trend for improved survival among patients who received radical surgery (HR, 0.71; 95% CI, 0.51-1.00; P =.05). Conclusion AA confers a significantly worse prognosis than SCCA and RA.

Original languageEnglish (US)
Pages (from-to)47-53
Number of pages7
JournalClinical Colorectal Cancer
Volume15
Issue number1
DOIs
StatePublished - Mar 1 2016

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Anal Canal
Squamous Cell Carcinoma
Adenocarcinoma
Survival
Confidence Intervals
Radiation
Anus Neoplasms
Kaplan-Meier Estimate
Natural History
Proportional Hazards Models
Epidemiology
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology

Cite this

Comparative Survival of Patients with Anal Adenocarcinoma, Squamous Cell Carcinoma of the Anus, and Rectal Adenocarcinoma. / Franklin, Robert A.; Giri, Smith; Valasareddy, Poojitha; Lands, Lindsey T.; Martin, Michael.

In: Clinical Colorectal Cancer, Vol. 15, No. 1, 01.03.2016, p. 47-53.

Research output: Contribution to journalArticle

Franklin, Robert A. ; Giri, Smith ; Valasareddy, Poojitha ; Lands, Lindsey T. ; Martin, Michael. / Comparative Survival of Patients with Anal Adenocarcinoma, Squamous Cell Carcinoma of the Anus, and Rectal Adenocarcinoma. In: Clinical Colorectal Cancer. 2016 ; Vol. 15, No. 1. pp. 47-53.
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title = "Comparative Survival of Patients with Anal Adenocarcinoma, Squamous Cell Carcinoma of the Anus, and Rectal Adenocarcinoma",
abstract = "Background Anal adenocarcinoma (AA) represents 5{\%} to 10{\%} of anal cancer. Little is known about its natural history and prognosis. Using population-based data, we defined the outcomes of AA relative to other anorectal malignancies. Patients and Methods We analyzed the Surveillance, Epidemiology, and End Results 18 database to identify patients ≥ 18 years old with AA, squamous cell carcinoma of the anus (SCCA), and rectal adenocarcinoma (RA) diagnosed between 1990 and 2011. Median overall survival (OS), 1-year, 3-year, 5-year, and 10-year OS were computed using actuarial methods. The log rank test was used to estimate the difference between Kaplan-Meier survival curves. A Cox proportional hazard regression model was used to adjust the effects of other covariates on survival, including age, year diagnosed, sex, stage, surgery, and radiation. Results Of 57,369 cases, 0.8{\%} (n = 462) were patients with AA, 87.8{\%} (n = 50,382) were patients with RA, and 11.4{\%} (n = 6525) were patients with SCCA. The median age for AA was 69 years (range, 20-96 years), 66 years (range, 18-103 years) for RA, and 66 years (range, 14-104 years) for SCCA. The median OS was significantly lower for AA (33 months), compared with SCCA (118 months) and RA (68 months) (P <.01). In multivariate analysis, AA had a worse prognosis compared with SCCA (hazard ratio [HR], 0.66; 95{\%} confidence interval [CI], 0.59-0.75; P <.01) and RA (HR, 0.68; 95{\%} CI, 0.61-0.77; P <.01), after adjusting for age, sex, race, stage, grade, radiation, and surgery. There was a strong trend for improved survival among patients who received radical surgery (HR, 0.71; 95{\%} CI, 0.51-1.00; P =.05). Conclusion AA confers a significantly worse prognosis than SCCA and RA.",
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T1 - Comparative Survival of Patients with Anal Adenocarcinoma, Squamous Cell Carcinoma of the Anus, and Rectal Adenocarcinoma

AU - Franklin, Robert A.

AU - Giri, Smith

AU - Valasareddy, Poojitha

AU - Lands, Lindsey T.

AU - Martin, Michael

PY - 2016/3/1

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N2 - Background Anal adenocarcinoma (AA) represents 5% to 10% of anal cancer. Little is known about its natural history and prognosis. Using population-based data, we defined the outcomes of AA relative to other anorectal malignancies. Patients and Methods We analyzed the Surveillance, Epidemiology, and End Results 18 database to identify patients ≥ 18 years old with AA, squamous cell carcinoma of the anus (SCCA), and rectal adenocarcinoma (RA) diagnosed between 1990 and 2011. Median overall survival (OS), 1-year, 3-year, 5-year, and 10-year OS were computed using actuarial methods. The log rank test was used to estimate the difference between Kaplan-Meier survival curves. A Cox proportional hazard regression model was used to adjust the effects of other covariates on survival, including age, year diagnosed, sex, stage, surgery, and radiation. Results Of 57,369 cases, 0.8% (n = 462) were patients with AA, 87.8% (n = 50,382) were patients with RA, and 11.4% (n = 6525) were patients with SCCA. The median age for AA was 69 years (range, 20-96 years), 66 years (range, 18-103 years) for RA, and 66 years (range, 14-104 years) for SCCA. The median OS was significantly lower for AA (33 months), compared with SCCA (118 months) and RA (68 months) (P <.01). In multivariate analysis, AA had a worse prognosis compared with SCCA (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.59-0.75; P <.01) and RA (HR, 0.68; 95% CI, 0.61-0.77; P <.01), after adjusting for age, sex, race, stage, grade, radiation, and surgery. There was a strong trend for improved survival among patients who received radical surgery (HR, 0.71; 95% CI, 0.51-1.00; P =.05). Conclusion AA confers a significantly worse prognosis than SCCA and RA.

AB - Background Anal adenocarcinoma (AA) represents 5% to 10% of anal cancer. Little is known about its natural history and prognosis. Using population-based data, we defined the outcomes of AA relative to other anorectal malignancies. Patients and Methods We analyzed the Surveillance, Epidemiology, and End Results 18 database to identify patients ≥ 18 years old with AA, squamous cell carcinoma of the anus (SCCA), and rectal adenocarcinoma (RA) diagnosed between 1990 and 2011. Median overall survival (OS), 1-year, 3-year, 5-year, and 10-year OS were computed using actuarial methods. The log rank test was used to estimate the difference between Kaplan-Meier survival curves. A Cox proportional hazard regression model was used to adjust the effects of other covariates on survival, including age, year diagnosed, sex, stage, surgery, and radiation. Results Of 57,369 cases, 0.8% (n = 462) were patients with AA, 87.8% (n = 50,382) were patients with RA, and 11.4% (n = 6525) were patients with SCCA. The median age for AA was 69 years (range, 20-96 years), 66 years (range, 18-103 years) for RA, and 66 years (range, 14-104 years) for SCCA. The median OS was significantly lower for AA (33 months), compared with SCCA (118 months) and RA (68 months) (P <.01). In multivariate analysis, AA had a worse prognosis compared with SCCA (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.59-0.75; P <.01) and RA (HR, 0.68; 95% CI, 0.61-0.77; P <.01), after adjusting for age, sex, race, stage, grade, radiation, and surgery. There was a strong trend for improved survival among patients who received radical surgery (HR, 0.71; 95% CI, 0.51-1.00; P =.05). Conclusion AA confers a significantly worse prognosis than SCCA and RA.

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