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Clinical Studies

Management of non-metastatic anal cancer in the elderly: ancillary study of the French multicenter prospective cohort FFCD-ANABASE

British Journal of Cancer volume 130, pages 769–776 (2024)Cite this article

Subjects

Abstract

Background

Standard care for non-metastatic squamous cell carcinoma of the anus (SCCA) is chemoradiotherapy, data about elderly patients are scarce.

Methods

All consecutive patients treated for non-metastatic SCCA from the French multicenter FFCD-ANABASE cohort were included. Two groups were defined according to age: elderly (≥75 years) and non-elderly (<75).

Results

Of 1015 patients, 202 (19.9%) were included in the elderly group; median follow-up was 35.5 months. Among the elderly, there were more women (p = 0.015); frailer patients (p < 0.001), fewer smokers (p < 0.001) and fewer HIV-infected (p < 0.001) than in the non-elderly group. Concomitant chemotherapy and inguinal irradiation were less frequent (p < 0.001 and p = 0.04). In the elderly group; 3-year overall survival (OS), recurrence-free survival (RFS) and colostomy-free survival (CFS) were 82.9%, 72.4% and 78.0%, respectively; complete response rate at 4–6 months was 70.3%. There were no differences between groups for all outcomes and toxicity. In multivariate analyses for the elderly, PS ≥ 2 and locally-advanced tumors were significantly associated with poor OS (HR = 3.4 and HR = 2.80), RFS (HR = 2.4 and HR = 3.1) and CFS (HR = 3.8 and HR = 3.0); and treatment interruption with poor RFS (HR = 1.9).

Conclusion

In the FFCD-ANABASE cohort, age did not influence tumor and tolerance outcomes of non-metastatic SCCA. Optimal curative treatment should be offered to elderly patients.

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Data availability

Researchers with appropriate proposals can request deidentified individual participant data. Data collected for the cohort, including participant data with identifiers and a data dictionary defining each field in the set, are not available. Requests should be sent to the corresponding author. The data will be shared after approval of a proposal, with a signed data access agreement.

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Funding

The FFCD-ANABASE cohort was supported by grants from the FFCD, France. The authors received no specific funding for this work.

Author information

Authors and Affiliations

  1. CHU Pontchaillou Rennes, Rennes, France

    Claire Gouriou & Astrid Lièvre

  2. Institut Régional du Cancer Montpellier, Montpellier, France

    Claire Lemanski

  3. Centre Léon Bérard Lyon, Lyon, France

    Pascal Pommier

  4. FFCD, Dijon, France

    Karine Le Malicot

  5. Centre Antoine Lacassagne Nice, Nice, France

    Angélique Saint

  6. CHU Tenon Paris, Paris, France

    Eleonor Rivin del Campo & Cécile Evin

  7. Hôpital St Louis Paris, Paris, France

    Laurent Quero

  8. Clinique Tivoli Bordeaux, Bordeaux, France

    Pauline Regnault

  9. Clinique St Joseph Paris, Paris, France

    Nabil Baba-Hamed

  10. Centre Azuréen de Cancérologie Mougins, Mougins, France

    Philippe Ronchin

  11. Centre Georges François Leclerc Dijon, Dijon, France

    Gilles Crehange

  12. CHU La Milétrie Poitiers, Poitiers, France

    David Tougeron

  13. CHD Vendée La Roche-sur-Yon, La Roche-sur-Yon, France

    Elodie Menager-Tabourel

  14. GHM Institut Daniel Hollard Grenoble, Grenoble, France

    Olivia Diaz

  15. Centre de Radiothérapie et d’Oncologie Béziers, Béziers, France

    Michael Hummelsberger

  16. Institut Curie Paris, Paris, France

    Anne de la Rocherfordiere

  17. Clinique Mutualiste de l’Estuaire St Nazaire, Saint-Nazaire, France

    Franck Drouet

  18. CHU Haut Lévêque Pessac Bordeaux, Bordeaux, France

    Véronique Vendrely

Authors
  1. Claire Gouriou
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  2. Claire Lemanski
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  5. Angélique Saint
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  6. Eleonor Rivin del Campo
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  19. Véronique Vendrely
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  20. Astrid Lièvre
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Contributions

All authors participated in the cohort. CG wrote the first draft of the manuscript and all authors participated in reviewing, correcting, and editing the manuscript. VV and KLM also participated in conceptualization of the cohort. KLM had access to the raw data and was involved in the formal analysis of the data. CG, VV, AL and KLM accessed and verified all the data. All authors had full access to the data in the cohort and had final responsibility for the decision to submit the publication. All authors approved the manuscript for submission and vouch for the accuracy and completeness of the data.

Corresponding author

Correspondence to Claire Gouriou.

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Competing interests

The authors declare no competing interests.

Ethics aproval and consent to participate

All patients received written information and provided oral informed consent and the cohort was approved by the ethics committee (CCTIRS-15.698) and the “Commission Nationale de l’Informatique et des Libertés” (authorization number 915,622).

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Gouriou, C., Lemanski, C., Pommier, P. et al. Management of non-metastatic anal cancer in the elderly: ancillary study of the French multicenter prospective cohort FFCD-ANABASE. Br J Cancer 130, 769–776 (2024). https://doi.org/10.1038/s41416-023-02564-9

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