Management of non-metastatic anal cancer in the elderly: ancillary study of the French multicenter prospective cohort FFCD-ANABASE.

Abstract

BACKGROUND:

Standard care for non-metastatic squamous cell carcinoma of the anus (SCCA) is chemoradiotherapy, data about elderly patients are scarce.

METHODS:

All consecutive patients treated for non-metastatic SCCA from the French multicenter FFCD-ANABASE cohort were included. Two groups were defined according to age: elderly (≥75 years) and non-elderly (<75).

RESULTS:

Of 1015 patients, 202 (19.9%) were included in the elderly group; median follow-up was 35.5 months. Among the elderly, there were more women (p = 0.015); frailer patients (p < 0.001), fewer smokers (p < 0.001) and fewer HIV-infected (p < 0.001) than in the non-elderly group. Concomitant chemotherapy and inguinal irradiation were less frequent (p < 0.001 and p = 0.04). In the elderly group; 3-year overall survival (OS), recurrence-free survival (RFS) and colostomy-free survival (CFS) were 82.9%, 72.4% and 78.0%, respectively; complete response rate at 4-6 months was 70.3%. There were no differences between groups for all outcomes and toxicity. In multivariate analyses for the elderly, PS ≥ 2 and locally-advanced tumors were significantly associated with poor OS (HR = 3.4 and HR = 2.80), RFS (HR = 2.4 and HR = 3.1) and CFS (HR = 3.8 and HR = 3.0); and treatment interruption with poor RFS (HR = 1.9).

CONCLUSION:

In the FFCD-ANABASE cohort, age did not influence tumor and tolerance outcomes of non-metastatic SCCA. Optimal curative treatment should be offered to elderly patients.

• Authors: Claire Gouriou, Claire Lemanski, Pascal Pommier, Karine Le Malicot, Angélique Saint, Eleonor Rivin Del Campo, Cécile Evin, Laurent Quero, Pauline Regnault, Nabil Baba-Hamed, Philippe Ronchin, Gilles Crehange, David Tougeron, Elodie Menager-Tabourel, Olivia Diaz, Michael Hummelsberger, Anne de la Rocherfordiere, Franck Drouet, Véronique Vendrely, Astrid Lièvre
• Journal: British journal of cancer (Br J Cancer) Vol. 130 Issue 5 Pg. 769-776 (Mar 2024) ISSN: 1532-1827 [Electronic] England
• PMID: 38184691 (Publication Type: Journal Article)
• Copyright: © 2024. The Author(s), under exclusive licence to Springer Nature Limited.

Topics

• Aged
• Female
• Humans
• Middle Aged
• Anus Neoplasms (pathology)
• Carcinoma, Squamous Cell (drug therapy)
• Chemoradiotherapy (adverse effects)
• Prospective Studies
• Multicenter Studies as Topic