Abstract
Introduction
for localized T1N0 squamous cell carcinoma of the anus (SCCA) standard radiotherapy
(RT) may result in overtreatment and alternative strategies are debated.
Methods
T1N0M0 SCCA treated between 2015 and 2020 by local excision (LE) or RT were analyzed
from the French prospective FFCD ANABASE cohort. Treatment strategies, recurrence-free
and colostomy-free survivals (RFS, CFS) and prognostic factors were reported.
Results
among 1135 SCCA patients, 99 T1N0M0 were treated by LE(n = 17,17.2%), or RT (n = 82,82.8%) including RT alone (n = 65,79.2%) or chemo-RT (n = 17, 20.7%). Median follow-up was 27.2 months [0.03–54.44]. Median tumor size were
11.4 mm [0.9–20] and 15.3 mm [2–20] in the LE and RT groups respectively. Mean RT
tumor dose was 59.4 Gy [18–69.4 Gy]. One patient in LE group and 9 in RT group had
a pelvic recurrence, either local (60%), nodal (10%) or both (30%). RFS and CFS at
24 months were 92.2%[95%CI,83.4–96.4] and 94.6%[95%CI,86.1–98.0], at 36 months 88.1%[95%CI,77.1–94.2]
and 88.5%[95%CI,77.0–94.5], in LE and RT group respectively, without any significative
difference (HR = 0.57;[95%CI,0.07–4.45];p = 0.60). By univariate analysis, male gender was the only prognostic factor(HR = 5.57;95%CI,
1.76–17.63; p = 0.004).
Conclusion
this cohort confirms the heterogeneity of T1N0M0 SCCA management, questioning the
place of RT alone, reduced dose or RT volume, and the safety of LE.
Keywords
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Article info
Publication history
Published online: April 16, 2021
Accepted:
March 12,
2021
Received:
November 10,
2020
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
