Increased occurrence of malignancy before and after chemoradiation for anal squamous cell carcinoma: a multi-institutional analysis.

IF 9.9 1区医学 Q1 ONCOLOGY

JNCI Journal of the National Cancer Institute Pub Date : 2025-04-01 DOI:10.1093/jnci/djae309

Ritesh Kumar, Chris L Hallemeier, Daniel T Chang, Shou-En Lu, Lara Hathout, Vasilis C Hristidis, Krishnan R Jethwa, J Richelcyn M Baclay, Veeraswamy Manne, Zakaria Chakrani, Michael G Haddock, Diego Augusto Santos Toesca, Erqi Liu Pollom, Abraham J Wu, Harigopal Sandhyavenu, Paul B Romesser, Salma K Jabbour

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引用次数: 0

Abstract

Background: Anal squamous cell carcinoma is a rare cancer with increased occurrence of multiple cancers before and after the anal squamous cell carcinoma diagnosis. However, there are limited data on this aspect. This multi-institutional analysis aimed to define the occurrence of malignancies before and after anal squamous cell carcinoma, time trends, and impact on survival and to identify prognostic factors.

Methods: Initial primary malignancy was defined as a malignancy occurring before the anal squamous cell carcinoma. Second primary malignancy was defined as a distinct primary cancer that developed after anal squamous cell carcinoma diagnosis. Retrospective multi-institutional chart review was done. Progression-free survival (PFS), overall survival, and prognostic factors were evaluated.

Results: A total of 647 patients with anal squamous cell carcinoma treated with curative intent were analyzed. Median age was 61.2 years with 72% as females. Of these, 150 (23.3%) patients had multiple malignancies with initial primary malignancy in 16% and second primary malignancy in 8%. Patients without prior cancer had better 5-year PFS (81.2% vs 67.2%, P = .011) and overall survival (81% vs 69%, P = .008) compared with those with prior cancer. Second primary malignancies had a statistically significant adverse impact on PFS (hazard ratio [HR] = 4.22) and overall survival (HR = 3.56). Females had better 5-year PFS (82% vs 70%, P = .016) as compared with males. The median time interval for developing anal squamous cell carcinoma (as second primary malignancy) after initial primary malignancy was 9.32 years.

Conclusions: Anal squamous cell carcinoma patients have an increased risk of multiple malignancies. These patients who have prior cancers have inferior outcomes. Second primary malignancy is a poor prognostic factor in patients with anal cancer. Second primary malignancy can develop years after treatment of primary anal squamous cell carcinoma.

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肛门鳞状细胞癌放化疗前后恶性肿瘤发生率增高：一项多机构分析。

背景：肛门鳞状细胞癌（ASCC）是一种罕见的癌症，在ASCC诊断前后多发。然而，这方面的数据有限。这项多机构分析旨在确定ASCC前后恶性肿瘤的发生，时间趋势，对生存的影响，并确定预后因素。材料和方法：初始原发性恶性肿瘤（IPM）被定义为发生在ASCC之前的恶性肿瘤。第二原发恶性肿瘤（SPM）被定义为在ASCC诊断后发展的一种独特的原发癌症。进行回顾性多机构图表审查。评估无进展生存期（PFS）、总生存期（OS）和预后因素。结果：分析了647例ASCC患者的治疗意图。中位年龄为61.23岁，其中72%为女性。150例（23.3%）有多发性恶性肿瘤，其中IPM占16%，SPM占8%。与既往癌症患者相比，无既往癌症患者的5年PFS （81.2% vs 67.2%, p = 0.011）和OS （81% vs 69%, p = 0.008）更好。SPMs对PFS （HR 4.22）和OS （HR 3.56）有显著的不利影响。与男性相比，女性有更好的5年PFS （82% vs 70%, p = 0.016）。IPM后发展为ASCC（作为SPM）的中位时间间隔为9.32年。结论：ASCC患者患多种恶性肿瘤的风险增加。既往患有癌症的患者预后较差。对于没有任何既往癌症的患者，SPM是一个预后不良的因素。原发性ASCC治疗多年后可发展为SPM。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JNCI Journal of the National Cancer Institute 医学-肿瘤学

CiteScore

17.00

自引率

2.90%

发文量

203

审稿时长

4-8 weeks

期刊介绍： The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.