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

• Published in: Digestive and liver disease Vol. 46; no. 5; pp. 460 - 464
• Main Authors: Claren, Audrey, Doyen, Jerôme, Falk, Alexander T., Benezery, Karen, Follana, Philippe, Frin, Anne-Claire, Hannoun-Lévi, Jean-Michel, Cavaglione, Gérard, Mari, Véronique, Gérard, Jean-Pierre, François, Eric
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2014
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Anal canal cancer; 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; Elderly; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Gastroenterology and Hepatology; Humans; Male; Middle Aged; Mitomycin - administration & dosage; Radiochemotherapy; Radiotherapy; Radiotherapy Dosage; Retrospective Studies; Survival Rate; Tumor Burden; Radiotherapy; Elderly; Anal canal cancer; Radiochemotherapy
• ISSN: 1590-8658; 1878-3562; 1878-3562
• DOI: 10.1016/j.dld.2014.01.004

Information concerning management of anal canal cancer among the elderly is scarce and much less abundant than for younger subjects. 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). 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. If radiochemotherapy can be delivered to elderly subjects with a good general status, the effects appear less favourable than in younger patients.