Gastrointestinal Cancer

PV QA 1 - Poster Viewing Q&A 1

SU_4_2032 - Small Cell Carcinoma of the Anus, A Patterns of Care Study Utilizing a Large Hospital-Based Database

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Small Cell Carcinoma of the Anus, A Patterns of Care Study Utilizing a Large Hospital-Based Database
V. W. Osborn1,2, E. L. Garay1,2, P. Adedoyin1,2, P. Y. Han2, J. Safdieh Jr3, and D. Schreiber4; 1Veterans Affairs NY Harbor Healthcare System, Brooklyn, NY, 2SUNY Downstate Medical Center, Brooklyn, NY, 3Department of Radiation Oncology, Kings County Hospital Center, Brooklyn, NY, 4Summit Medical Group MD Anderson Cancer Center, Berkeley Heights, NJ

Purpose/Objective(s): To utilize the National Cancer Database (NCDB) to characterize the clinical characteristics and treatment patterns of small cell carcinoma of the anus.

Materials/Methods: The National Cancer Database (NCDB) was queried to identify patients diagnosed with small cell carcinoma of the anus between 2004 and 2014. Patient demographics and staging characteristics were collected as well as treatments administered. Kaplan-Meier comparisons with log rank analyses were performed to compare outcomes of patients with different stages as well as for nonmetastatic patients receiving chemoradiation (CRT) compared with radiation therapy (RT) alone. Multivariable analysis (MVA) was performed using Cox Regression to assess for predictors of improved overall survival (OS) for the following factors: age (<60, 60+), sex (male, female), race (white, black, other), Charlson-Deyo Comorbidity Index (0, 1 or 2+), facility type (academic, nonacademic), insurance status (none, private, Medicaid, Medicare, other), stage grouping (I, II, IIIA, IIIB, IV), type of surgery performed (none, local/biopsy, abdominoperineal resection (APR), not otherwise specified (NOS)), and receipt of CRT.

Results: A cohort of 213 patients was identified with a median follow up of 13.5 months, 27.8 months for living patients. The median age was 61 (range 32-89). The patients were mostly female (65.3%), and white (82.6%). The most common cT stage was T2 (31.5%) followed by TX (29.1%). Stage groupings were fairly evenly distributed, 13.1% stage I, 16.0% stage II, 13.1% stage IIIA, 22.9% stage IIIB and 34.9% stage IV. 45.5% of patients were node positive. Overall, 29.1% of patients underwent surgery, 22.5% local excision/biopsy, 5.2% APR +/- LND and 1.4% NOS. 68.1% of patients received RT and 85.4% received chemotherapy. This was commonly given via concurrent chemoradiation (n=61, 28.6%) or neoadjuvant chemotherapy followed by radiotherapy (n=59, 27.7%). Estimated median survival durations were 23.9, 23.2, 23.5, 17.9 and 9.5 months for stages I, II, IIIA, IIIB and IV. On MVA, receipt of CRT was found to be associated with improved survival (HR 0.583, 95% confidence interval (CI) 0.359-0.949, p=0.030), while higher stage was associated with worse survival. For nonmetastatic patients (stages I-IIIB), CRT was also associated with improved OS compared with RT alone on Kaplan-Meier analysis (p<0.0001).

Conclusion: Although rare, small cell carcinoma of the anus showed a female and white predominance. Almost half of patients presented with positive nodes and over 1/4 with metastatic disease. Chemotherapy and/or radiation were the most common treatment strategies, and for nonmetastatic patients concurrent chemoradiation was associated with a survival benefit over RT alone on MVA.

Author Disclosure: V.W. Osborn: None. E.L. Garay: None. P.Y. Han: None. D. Schreiber: None.

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