Year: 2025
Type: conference-abstract
Study design: Observational Study
Abstract: e15502 Background: Localized anal cancer (LAC) is a rare malignancy, with limited data on treatment tolerance and outcomes in elderly patients (pts). We conducted a real-world data analysis to evaluate the safety and efficacy of standard treatments with curative intent in this population. Methods: This retrospective cohort evaluates the Sao Paulo Cancer Institute electronic medical records database between 2017-2024. The primary endpoint was overall survival (OS), and secondary endpoints were disease-free survival (DFS) and safety in pts ≥ 65y with LAC. Results: Among the 551 pts database, 192 (34.8%) had ≥65 years(y), and 178 were included in the study. Age distribution was 46.8% in 65–75y and 53.1% >75y. Most patients were female (75.8%), had squamous cell carcinoma (95.9%), and had an ECOG performance status of 0–1 (81.2%), with 7.9% being HIV-positive. 89.9% (n=160) had LAC, 60.7% stage III at diagnosis. 155 (96.9%) received curative treatment, with concurrent CRT in 85%. CRT regimens included fluoropyrimidine (FP) plus cisplatin (CDDP) in 44.8%, FP plus mitomycin (MMC) in 29%, and FP in 28.7%. Of 105 pts with 6-month (m) radiologic evaluations, 60% achieved complete response. At a median follow-up of 49 months, 39 pts experienced recurrence, and 51 died, with anal cancer-related deaths in 70.1%. Grade ≥3 adverse events (AE) occurred in 61.1%. Treatment discontinuation due to AE occurred in 27%, hospitalization in 24.3%, and treatment-related death in 4.8%. Patients receiving FP+MMC had higher rates of treatment discontinuation due to toxicity (43.1% vs. 13.6%, P=0.001) and febrile neutropenia (10.4% vs. 1.8%, P=0.021) compared to those receiving FP+CDDP. The 5y OS was significantly higher in pts ≤ 75y (table). Conclusions: A high proportion of anal cancer cases occur in elderly pts. In this cohort, we found considerable rates of toxicity and treatment-related mortality, with safety concerns particularly pronounced in the FP+MMC CRT group. Poor 5y DFS and OS were observed in patients with >75 years. Oncologic outcomes. 5-year DFS HR (95%CI) 5-year OS HR (95%CI) Stage I 80% ref 80% ref Stage II 71.9% 2.35 (0.41-17.92) 82.1% 1.48 (0.18-11.77) Stage III 51.3% 3.49 (0.48-25.42) 58.8% 2.94 (0.40-21.50) RT alone 57.1% ref 57.1% ref CRT with single agent 55% 0.96 (0.31-2.97) 50.7% 0.84 (0.28-2.52) CRT with FP+CDDP 59.7% 0.74 (0.28-1.94) 70.9% 0.47 (0.17-1.27) CRT with FP+MMC 58.9% 0.72 (0.27-1.92) 72.6% 0.39 (0.14-1.07) 65-75y 70% ref 79.9% ref >75y 46.3% 2.52 (1.48-4.28) 52.3% 3.31 (1.78-6.12)
Source: Journal of Clinical Oncology
Authors: Camila M. Venchiarutti Moniz, Renata Colombo Bonadio, Letícia Hannah de Souza Estanislau, Maria Ignez Braghiroli, Murilo Cazellato Pacheco De Mello, Denis Galhera, Carolina Ribeiro Victor, Carlos Frederico Marques, Luciana Bastos Valente Alban, Andre Tsin Chih Chen, Caio Nahas, Jorge Sabbaga, Paulo Marcelo Hoff
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410820849