Impact of advancing age on treatment and outcomes in anal cancer

Figures & data

Table I. Baseline patient characteristics.

	All patients (n = 284) N (%) or median (range)	Age < 50 (n = 51) N (%) or median (range)	Age 50–69 yrs (n = 140) N (%) or median (range)	Age > 70 yrs (n = 93) N (%) or median (range)	p-value for association with age group
Age at diagnosis	62 years (27–89)	43 (27–49)	59 (50–59)	77 (70–89)	< 0.0001
Female	187 (66%)	39 (76%)	83 (59%)	65 (70%)	0.90
Tumor site Anal margin/verge Anal canal Both	35 (12%) 192 (68%) 57 (20%)	9 (18%) 34 (67%) 8 (16%)	16 (11%) 95 (68%) 29 (21%)	10 (11%) 63 (68%) 20 (22%)	0.51
Primary tumor diameter (cm)	4 (0.5–14)	3 (1–14)	4 (0.5–10)	3.1 (1–10)	0.21
T stage T1 T2 T3 T4 Tx	69 (24%) 135 (48%) 35 (12%) 42 (15%) 3 (1%)	17 (33%) 18 (35%) 4 (8%) 11 (22%) 1 (2%)	35 (25%) 66 (47%) 20 (14%) 18 (13%) 1 (1%)	17 (18%) 51 (55%) 11 (12%) 13 (14%) 1 (1%)	0.16
N stage N0 N1 N2 N3	230 (81%) 6 (2%) 28 (10%) 20 (7%)	43 (84%) 6 (12%) 2 (4%)	111 (79%) 4 (3%) 14 (10%) 11 (8%)	76 (82%) 2 (2%) 8 (9%) 7 (8%)	0.79
AJCC Stage (7th edition) I II III IV Missing	66 (23%) 135 (48%) 29 (10%) 51 (18%) 3	17 (34%) 17 (34%) 8 (16%) 8 (16%) 1	33 (24%) 67 (48%) 13 (9%) 26 (19%) 3	16 (17%) 51 (55%) 8 (9%) 17 (18%) 3	0.05

Table II. Treatment characteristics.

	All patients (n = 284) N (%) or median (range)	Age < 50 (n = 51) N (%) or median (range)	Age 50–69 yrs (n = 140) N (%) or median (range)	Age > 70 yrs (n = 93) N (%) or median (range)	p-value for association with age group
Planned RT dose (Gy)	54 (45–66)	54 (50–66)	54 (45–66)	54 (45–60)	0.76
Actual RT duration (days)	39 (7–89)	41 (19–82)	39 (7–74)	41 (22–89)	0.80
Completed CRT	270 (95%)	51 (100%)	135 (96%)	84 (90%)	0.006
Required unplanned RT break	90 (32%)	20 (39%)	39 (28%)	31 (33%)	0.75
Unplanned break days*	11 (2–47)	10 (5–30)	13 (3–30)	11 (2–47)	0.36
5-FU regimen					0.77
One course	18 (6%)	2 (4%)	13 (9%)	3 (3%)
Two course	124 (45%)	24 (47%)	62 (45%)	38 (43%)
Protracted venous infusion	110 (40%)	20 (39%)	49 (36%)	41 (47%)
5-FU chemotherapy
Required dose reduction
Course 1	3 (3%)	0	1 (2%)	2 (6%)	0.16
Course 2	14 (16%)	4 (22%)	7 (16%)	3 (10%)	0.27
MMC chemotherapy
Received 1 dose of MMC	245 (86%)	45 (88%)	120 (86%)	80 (86%)	0.78

*applicable only to patients whom had a RT break.

Table III. Acute toxicity requiring treatment break.

	All patients (n = 284) N (%)	Age < 50 (n = 51) N (%)	Age 50–69 yrs (n = 140) N (%)	Age > 70 yrs (n = 93) N (%)	p-value for association with age group
Skin toxicity	63 (22%)	16 (31%)	29 (21%)	18 (19%)	0.15
Diarrhea	5 (2%)	0	0	5 (5%)	0.004
Hematologic	2 (1%)	0	2 (1%)	0	0.69
Combination	19 (7%)	4 (8%)	7 (5%)	8 (9%)	0.63
Other	8 (3%)	0 (0%)	4 (3%)	4 (4%)	0.15

Figure 1. Overall survival by age group, using age cut-off of > 70 years for Group 3.

Table IV. Patterns of recurrenceˆ and colostomy.

	All patients	Age < 50	Age 50–69 yrs	Age > 70 yrs
Any recurrence	54	9	33	12
Local recurrence	24	4	14	6
Pelvic nodal recurrence	5	2	2	1
Inguinal nodal recurrence	9	2	6	1
Combination loco-regional recurrence*	5	0	4	1
Distant recurrence	17	2	10	5
Number with colostomy	38	5	23	10

ˆpatients may have a combination of loco-regional and distant recurrences; *patients with any combination of local, pelvic and/or inguinal nodal recurrence.

Figure 2. Local-recurrence free survival by age group, using age cut-off of > 70 years for Group 3.

Figure 3. Disease-free survival by age group, using age cut-off of > 70 years for Group 3.