Anal cloacogenic carcinoma has the same prognosis of the squamous cell carcinoma: case control study of 30 patients
Résumé
Case-control study comparing overall survival and disease free survival for patients with squamous cell carcinoma of the anus (ASCC) and transitional clocacogenic carcinoma (CCA). Material and methods: 450 patients were supported between January 2001 and December 2014, cancer of the anal canal. 15 patients with CCA were selected and matched (1 for 1) by age, sex, tumor stage (clinical, radiological, and histological) and HIV infection and HPV status in patients group of ASCC. Overall survival and disease free survival in both groups were studied. After initial treatment, the persistence of the lesion histologically proven before 6 months after treatment was defined as a residual disease (MR), the occurrence of a local recurrence was defined as a lesion histologically proved after 6 months of starting treatment. Statistical analysis was done using the Chi 2 test and the Student test, and survival curves were determined using the Kaplan-Meier. Results: There were 26 women, median age was 67.5 (55-83) years. HPV and HIV infection rate was 0 and 40% respectively. The distribution of stages I, II, IIIA, IIIB and IV was 13.3% (n=4), 40% (n=12), 26.6% (n=8), 13.3% (n=4), and 6.6% (n=2) respectively. 83.3% of patients were treated with radiochemotherapy with no difference between the two groups. Six patients underwent abdominoperineal resection 4 for residual disease (2 in each group), and 2 for locoregional recurrence (1 in each group). The median overall follow-up was 41 months (3-108 months) with no difference between groups. Overall survival at 3 and 5 years was not different between the two groups and CCA group CEA respectively 85%; 75% vs. 87.5%; 73% (NS). The overall survival at 3 and 5 years without colostomy was not different between the two CCA group and CEA groups (respectively 80%; 46% vs 78.7%; 56% (NS)). Disease-free survival at 3 and 5 years was similar in both CCA and ASCC groups (respectively 84%, 46% vs 69%; 46% (NS)). Conclusion: This study demonstrates that stage equivalent prognosis of ASCC and CCA is comparable.