Esin Ece, Yıldız Ferah, Laçin Şahin, Karakaş Yusuf, Gültekin Melis, Dizdar Ömer, Yalçın Şuayib
Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
Department of Radiation Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
Turk J Gastroenterol. 2018 Jul;29(4):411-418. doi: 10.5152/tjg.2018.17660.
BACKGROUND/AIMS: An organ preservation approach using chemoradiotherapy has been established for anal cancer. This retrospective cohort study aimed to define the clinico-demographic characteristics and outcomes of cases of human immunodeficiency virus (HIV)-negative anal carcinoma during a period of 20 years in a single comprehensive cancer institute.
This was a single-center retrospective cohort study of patients who were treated between January 1995 and January 2015. The primary outcome measures that were investigated included overall survival (OS), progression-free survival (PFS), colostomy rates, and colostomy-free survival (CFS).
A total of 28 patients who were principally treated with standard 5-fluorouracil + mitomycin combination chemoradiotherapy were eligible for analysis. The 3- and 5-year PFS rates were 92.4% and 63%, respectively. The lower T stage was found to be associated with a prolonged PFS (p=0.001). The 3- and 5-year CFS rates were 84.3% and 74.9%, respectively. A longer CFS was observed with lower T stages (p=0.05). At the last follow-up, 75% of the patients with anal cancer were alive, and 71.4% of the patients were disease free. The median OS was not reached with a median follow-up of 54 months (range, 6-115 months). The 3- and 5-year OS rates were 82% and 71.1%, respectively. No late toxicity was observed during the follow-up period.
The short- and long-term prognoses of HIV-negative patients with anal squamous cell carcinoma were good, and low-grade toxicity was rare, thereby demonstrating that these patients can be successfully treated in a real-life setting with favorable outcomes.
背景/目的：已确立了一种采用放化疗的肛管癌器官保留方法。这项回顾性队列研究旨在明确在一家综合性癌症中心20年间人类免疫缺陷病毒（HIV）阴性肛管癌病例的临床人口统计学特征及预后。
这是一项对1995年1月至2015年1月期间接受治疗的患者进行的单中心回顾性队列研究。所调查的主要结局指标包括总生存期（OS）、无进展生存期（PFS）、结肠造口术发生率和无结肠造口生存期（CFS）。
共有28例主要接受标准5-氟尿嘧啶+丝裂霉素联合放化疗的患者符合分析条件。3年和5年PFS率分别为92.4%和63%。发现较低的T分期与较长的PFS相关（p=0.001）。3年和5年CFS率分别为84.3%和74.9%。较低的T分期观察到更长的CFS（p=0.05）。在最后一次随访时，75%的肛管癌患者存活，71.4%的患者无疾病。中位随访54个月（范围6 - 115个月）时未达到中位OS。3年和5年OS率分别为82%和71.1%。随访期间未观察到晚期毒性反应。
HIV阴性肛管鳞状细胞癌患者的短期和长期预后良好，低级别毒性罕见，这表明这些患者在现实环境中可得到成功治疗并获得良好结局。
