Clinical characteristics and prognosis of anal squamous cell carcinoma: a retrospective audit of 144 patients from 11 cancer hospitals in southern China
Clinical characteristics and prognosis of anal squamous cell carcinoma: a retrospective audit of 144 patients from 11 cancer hospitals in southern China
复制标题
肛门鳞状细胞癌的临床特征及预后：华南地区11家肿瘤医院144例患者的回顾性分析
DOI：
10.1186/s12885-020-07170-z
复制
发表时间：
2020-07-21
期刊：
影响因子：
3.8
通讯作者：
Zou, Huachun
中科院分区：
文献类型：
--
作者：
Lu, Yong;Wang, Xiaohao;Zou, Huachun
背景肛门鳞状细胞癌（anal squamous cell carcinoma，SCC）的发病率在过去的十年中在全球范围内稳步上升。来自中国的肛门SCC的临床数据是罕见的。我们进行了这项研究，以描述中国肛门SCC的临床和流行病学特征，并探讨肛门SCC患者预后的影响因素。2007年1月至2018年7月，中国11家医疗机构诊断为肛门鳞状细胞癌患者的治疗方式和结果。（109名女性）在此期间被诊断为SCC。初次诊断时的中位年龄为52.0岁（四分位数间距：46.0-61.8）。最常见的症状是出血（n= 93，64.6%），注意到肿块（n= 49，34.0%）和疼痛（n= 47，32.6%）。美国癌症联合委员会（AJCC）I-IV期患者比例分别为10例（6.9%）、22例（15.3%）、61例（42.4%）和8例（5.6%），43例（29.9%）患者的AJCC分期未知。36例患者（25.0%）接受了腹会阴联合切除术。单因素分析显示T分期预测无复发生存期（RFS）（风险比[HR] = 3.03，95%置信区间[CI]：1.10- 8.37，p = 0.032），和年龄组（HR = 2.90，95%CI：1.12- 7.49，p = 0.028），AJCC分期（HR = 4.56，95%CI：1.02- 20.35，p = 0.046），N分期（HR = 3.05，95% CI：1.07- 8.74，p = 0.038）预测总生存期。结论T分期是RFS的预后因素，年龄、AJCC分期、和N分期被确定为OS的预后因素。应鼓励提高患者的症状意识和早期表现在潜在的肛门SCC的风险。应进一步提高中国卫生保健提供者对标准治疗的熟悉程度。
BackgroundThe incidence of anal squamous cell carcinoma (SCC) has been steadily growing globally in the past decade. Clinical data on anal SCC from China are rare. We conducted this study to describe the clinical and epidemiological characteristics of anal SCC in China and explore prognostic factors of outcomes among patients with anal SCC.MethodsWe audited demographic characteristics, relevant symptoms, risk factors, treatment modalities and outcomes for patients diagnosed with anal SCC at 11 medical institutions in China between January 2007 and July 2018.ResultsA total of 144 patients (109 females) were diagnosed with SCC during this period. Median age at initial diagnosis was 52.0 (interquartile range: 46.0–61.8) years. The most common symptoms were bleeding (n= 93, 64.6%), noticing a lump (n= 49, 34.0%), and pain (n= 47, 32.6%). The proportion of patients at the American Joint Committee on Cancer (AJCC) stages I-IV were 10 (6.9%), 22 (15.3%), 61 (42.4%) and 8 (5.6%), respectively, and AJCC stages in 43 (29.9%) patients were unknown. Thirty-six patients (25.0%) underwent abdominoperineal resection initially. Univariable analysis showed that T stage predicted recurrence-free survival (RFS) (Hazard ratio [HR] = 3.03, 95% Confidence interval [CI]: 1.10–8.37,p= 0.032), and age group (HR = 2.90, 95% CI: 1.12–7.49,p= 0.028), AJCC stage (HR = 4.56, 95% CI: 1.02–20.35,p= 0.046), and N stage (HR = 3.05, 95% CI: 1.07–8.74,p= 0.038) predicted overall survival (OS).ConclusionsT stage was identified as prognostic factor of RFS, and age, AJCC stage, and N stage were identified as prognostic factors of OS. Improving symptom awareness and earlier presentation among patients potentially at risk for anal SCC should be encouraged. Familiarity with the standard treatment among health care providers in China should be further improved.