Materiały źródłowe

• #1 Treatment of Stage I-III Squamous Cell Anal Cancer | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/anal-cancer-treatment/protocol

  Although anal cancer only represents 1-2 percent of all gastrointestinal malignancies, incidence has risen steadily by 2-3 percent a year over the past decade. Squamous cell carcinoma (SCC) is by far the most common type, accounting for over 90 percent of anal malignancies, and risk factors include female gender, Black race, and men who have sex with men (MSM). A well-defined relationship also exists between human papilloma virus (HPV) and squamous cell carcinoma of the anus, particularly HPV serotypes 16 and 18. Treatment of SCC of the anal canal includes chemotherapy, radiation, and/or surgical intervention. Depending on the initial staging, treatment may yield a five-year survival up to 89 percent. […] Treatment, survival, and quality of life vary with stage of disease and tumor location. The National Comprehensive Cancer Network guidelines recommend chemoradiation as first line treatment for stage I-III tumors. The standard radiation protocol generally follows a 30-45 Gy dose delivered over a 3.5-5 week period with a boost of an additional 5-24 Gy for most situations. These regimens present significant toxicity, which has led to increasing interest in alternative treatments to balance benefits and harms.

• #2 Anal Cancer Survival Rates | Anal Cancer Prognosis | American Cancer Society

  https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/survival-rates.html

  Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] The SEER database tracks 5-year relative survival rates for anal cancer in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment.

• #3 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Anal cancer is a rare type of cancer. It generally has a good outlook (82% relative survival rate) when its caught in the early stages. But that outlook drops if the cancer has spread to other parts of your body. […] On average, people with anal cancer live at least 5 years about 69% as often as people without anal cancer. The stage of your cancer at the time of your diagnosis strongly influences your outlook. […] Your cancer stage at the time of your diagnosis is one of the most important factors that determine your chances of survival. Anal cancer has the best outlook when it hasnt spread to distant parts of your body. […] The 5-year relative survival rate is a measure of how many people with the cancer are alive 5 years later compared with people without the cancer. […] More than 90% of anal cancers are squamous cell carcinoma. This type of cancer starts in squamous cells that line your anus. Its survival rate is similar to anal cancer in general since it makes up the majority of these cancers.

• #4 Survival statistics for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival/survival-statistics

  Survival statistics for anal cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, the 5-year net survival for anal cancer is 64%. This means that, on average, 64% of people diagnosed with anal cancer will survive for at least 5 years. […] Survival varies with each stage of anal cancer. Generally, the earlier anal cancer is diagnosed and treated, the better the outcome. […] Survival by stage of anal cancer is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer but who share similar characteristics (such as age and sex).

• #5 Survival for anal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/anal-cancer/survival

  Around 60 out of 100 people (around 60%) will survive their cancer for 5 years or more after diagnosis. […] Around 20 out of 100 people (around 20%) will survive their cancer for 5 years or more after they are diagnosed. […] Generally, for people with anal cancer in England: 85 out of 100 people (85%) survive their cancer for 1 year or more, more than 60 out of 100 people (more than 60%) survive their cancer for 5 years or more, more than 50 out of 100 people (more than 50%) survive their cancer for 10 years or more. […] Your outcome depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread. […] Some studies show that survival is better for women than men.

• #6 Anal Cancer: Symptoms, Causes, Diagnosis, and Treatment

  https://www.webmd.com/cancer/what-is-anal-cancer

  The American Cancer Society estimated that 10,540 cases of anal cancer will be diagnosed in 2024 and about 2,190 deaths may occur that year from anal cancer. […] Approximately half of all anal cancers are diagnosed before the malignancy has spread beyond the primary site, whereas 13% to 25% are diagnosed after the cancer has spread to the lymph nodes, and 10% are diagnosed after the cancer has spread to distant organs, or has metastasized. […] When it is found early, anal cancer is highly treatable. […] The overall five-year survival rate following diagnosis of anal cancer is 64%. […] Immunocompromised patients, such as those with HIV disease, are prone to get anal cancer. In this subgroup, the prognosis is worse than for non-immunocompromised patients.

• #7 Survival statistics for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival/survival-statistics

  Survival statistics for anal cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, the 5-year net survival for anal cancer is 64%. This means that, on average, 64% of people diagnosed with anal cancer will survive for at least 5 years. […] Survival varies with each stage of anal cancer. Generally, the earlier anal cancer is diagnosed and treated, the better the outcome. […] Survival by stage of anal cancer is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer but who share similar characteristics (such as age and sex).

• #8 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #9 Factors Influencing Outcomes and Survival in Anal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11431442/

  Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] The median follow-up time for the study was 29.8 months. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.1312.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.1310.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.1122.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.2826.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] Expectantly, T4 tumours had a worse survival compared to those with other stages (* p = 0.02), as did those with nodal disease (* p = 0.02), metastases (* p = 0.001), or poor differentiation at the time of diagnosis (* p = 0.002) (Table 2 and Figure 1AD).

• #10 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Anal cancer is a rare type of cancer. It generally has a good outlook (82% relative survival rate) when its caught in the early stages. But that outlook drops if the cancer has spread to other parts of your body. […] On average, people with anal cancer live at least 5 years about 69% as often as people without anal cancer. The stage of your cancer at the time of your diagnosis strongly influences your outlook. […] Your cancer stage at the time of your diagnosis is one of the most important factors that determine your chances of survival. Anal cancer has the best outlook when it hasnt spread to distant parts of your body. […] The 5-year relative survival rate is a measure of how many people with the cancer are alive 5 years later compared with people without the cancer. […] More than 90% of anal cancers are squamous cell carcinoma. This type of cancer starts in squamous cells that line your anus. Its survival rate is similar to anal cancer in general since it makes up the majority of these cancers.

• #11 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #12 Factors Influencing Outcomes and Survival in Anal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11431442/

  Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] The median follow-up time for the study was 29.8 months. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.1312.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.1310.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.1122.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.2826.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] Expectantly, T4 tumours had a worse survival compared to those with other stages (* p = 0.02), as did those with nodal disease (* p = 0.02), metastases (* p = 0.001), or poor differentiation at the time of diagnosis (* p = 0.002) (Table 2 and Figure 1AD).

• #13 Factors Influencing Outcomes and Survival in Anal Cancer

  https://www.mdpi.com/1718-7729/31/9/381

  Factors Influencing Outcomes and Survival in Anal Cancer […] Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] The multivariable analysis highlighted key significant predictors of survival. Complete response to dCRT, advanced disease stage at diagnosis (T4), poorly differentiation of the neoplasm, nodal involvement (N2), and metastatic disease were significant factors influencing outcomes.

• #14 Survival for anal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/anal-cancer/survival

  Survival depends on different factors. So no one can tell you exactly how long you will live. […] Doctors usually work out the outlook for a certain disease by looking at large groups of people. Because this cancer is less common, survival is harder to estimate than for other, more common cancers. […] Your outlook (prognosis) depends on the stage of your cancer at diagnosis. […] There are no UK-wide statistics available for anal cancer survival by stage. […] Survival statistics are available for anal cancer in England. These figures are for people diagnosed between 2015 and 2019. […] Almost 90 out of 100 people (almost 90%) will survive their cancer for 5 years or more after diagnosis. […] More than 75 out of 100 people (more than 75%) will survive their cancer for 5 years or more after diagnosis.

• #15 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #16 Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09729-4

  Anal cancer is primarily treated using concurrent chemoradiotherapy (CRT), with conformal techniques such as intensity modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) now being the standard techniques utilised across the world. […] Despite this, there is still very limited consensus on prognostic factors for outcome following conformal CRT. […] The results from 19 studies were analysed. In both univariable and multivariable analysis, N stage, T stage, and sex were found to be the most prevalent and reliable clinical prognostic factors for the majority of outcomes explored. […] Establishing a set of prognostic and potentially predictive factors for anal cancer outcomes can guide the risk stratification of patients, aiding the design of future clinical trials. […] N stage, T stage, and sex were established as the most prevalent and reliable clinical prognostic factors for the majority of outcomes explored, in both UVA and MVA.

• #17 Factors Influencing Outcomes and Survival in Anal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11431442/

  The following factors were associated with better survival on univariate analysis: complete response to dCRT HR = 0.058, (95% CI 0.0120.28, * p = 0.0001), negative nodal status HR = 0.29, (95% CI 1 0.110.82, * p = 0.02). The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.1312.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.1310.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.1122.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.2826.42, * p = 0.02) (Table 2). […] This study highlights the critical prognostic factors in anal cancer management, including tumour stage, nodal status, and histological differentiation.

• #18 Factors Influencing Outcomes and Survival in Anal Cancer

  https://www.mdpi.com/article/10.3390/curroncol31090381?type=check_update&version=1

  Factors Influencing Outcomes and Survival in Anal Cancer […] Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] The following factors were associated with better survival on univariate analysis: complete response to dCRT HR = 0.058, (95% CI 0.012–0.28, * p = 0.0001), negative nodal status HR = 0.29, (95% CI 1 0.11–0.82, * p = 0.02). The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] The 3-year OS for the entire cohort was 76.1%, reducing to 57.14% in those requiring salvage APR. […] Recurrence remains a significant challenge in the management of anal cancer, with 8% of patients experiencing local recurrence and 6.7% developing distant metastases. Our analysis showed that recurrence was a strong predictor of poor survival (p = 0.006), emphasising the need for vigilant post-treatment surveillance and potential adjuvant therapies to mitigate the risk of recurrence.

• #19 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #20 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #21 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Cancer of the perianal skin tends to be diagnosed at an earlier stage, which also means it tends to have a better outlook. […] In a 2022 review of studies, researchers found that male sex and cancer spread to lymph nodes typically led to worse overall survival and a higher chance of treatment failure. […] People with a diagnosis of anal cancer at a younger age tend to have a better chance of survival than people who received a diagnosis at a later age. […] Most studies in the 2022 review of studies identified better performance status as a factor linked to a better outlook. […] In the 2022 review of studies, researchers found that lower detectable levels of HPV 16 were associated with a better outcome in 2 out of 3 of the studies they reviewed. […] Its well established that access to quality healthcare is linked to better outcomes in people with cancer due to improved time to diagnosis and treatment.

• #22 Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09729-4

  Anal cancer is primarily treated using concurrent chemoradiotherapy (CRT), with conformal techniques such as intensity modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) now being the standard techniques utilised across the world. […] Despite this, there is still very limited consensus on prognostic factors for outcome following conformal CRT. […] The results from 19 studies were analysed. In both univariable and multivariable analysis, N stage, T stage, and sex were found to be the most prevalent and reliable clinical prognostic factors for the majority of outcomes explored. […] Establishing a set of prognostic and potentially predictive factors for anal cancer outcomes can guide the risk stratification of patients, aiding the design of future clinical trials. […] N stage, T stage, and sex were established as the most prevalent and reliable clinical prognostic factors for the majority of outcomes explored, in both UVA and MVA.

• #23 Survival for anal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/anal-cancer/survival

  Around 60 out of 100 people (around 60%) will survive their cancer for 5 years or more after diagnosis. […] Around 20 out of 100 people (around 20%) will survive their cancer for 5 years or more after they are diagnosed. […] Generally, for people with anal cancer in England: 85 out of 100 people (85%) survive their cancer for 1 year or more, more than 60 out of 100 people (more than 60%) survive their cancer for 5 years or more, more than 50 out of 100 people (more than 50%) survive their cancer for 10 years or more. […] Your outcome depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread. […] Some studies show that survival is better for women than men.

• #24 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #25 Factors Influencing Outcomes and Survival in Anal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11431442/

  Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] The median follow-up time for the study was 29.8 months. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.1312.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.1310.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.1122.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.2826.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] Expectantly, T4 tumours had a worse survival compared to those with other stages (* p = 0.02), as did those with nodal disease (* p = 0.02), metastases (* p = 0.001), or poor differentiation at the time of diagnosis (* p = 0.002) (Table 2 and Figure 1AD).

• #26 Factors Influencing Outcomes and Survival in Anal Cancer

  https://www.mdpi.com/1718-7729/31/9/381

  Factors Influencing Outcomes and Survival in Anal Cancer […] Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] The multivariable analysis highlighted key significant predictors of survival. Complete response to dCRT, advanced disease stage at diagnosis (T4), poorly differentiation of the neoplasm, nodal involvement (N2), and metastatic disease were significant factors influencing outcomes.

• #27 Prognosis and survival for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] The following are prognostic factors for anal cancer. […] Anal tumours smaller than 2 cm have a better prognosis than larger tumours. Tumours larger than 5 cm tend to have a poor prognosis. […] Anal cancer that hasn’t spread to lymph nodes has a better prognosis than cancer that has spread to lymph nodes. The number of lymph nodes that the cancer has spread to and the size of the lymph nodes does not affect prognosis. […] Low-grade anal tumours have a better prognosis than high-grade tumours. […] Women have a better prognosis than men when diagnosed with anal cancer. […] Squamous cell carcinomas of the anus have a better prognosis than adenocarcinoma and other rare anal cancers.

• #28 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Anal cancer is a rare type of cancer. It generally has a good outlook (82% relative survival rate) when its caught in the early stages. But that outlook drops if the cancer has spread to other parts of your body. […] On average, people with anal cancer live at least 5 years about 69% as often as people without anal cancer. The stage of your cancer at the time of your diagnosis strongly influences your outlook. […] Your cancer stage at the time of your diagnosis is one of the most important factors that determine your chances of survival. Anal cancer has the best outlook when it hasnt spread to distant parts of your body. […] The 5-year relative survival rate is a measure of how many people with the cancer are alive 5 years later compared with people without the cancer. […] More than 90% of anal cancers are squamous cell carcinoma. This type of cancer starts in squamous cells that line your anus. Its survival rate is similar to anal cancer in general since it makes up the majority of these cancers.

• #29 Treatment of Stage I-III Squamous Cell Anal Cancer | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/anal-cancer-treatment/protocol

  Although anal cancer only represents 1-2 percent of all gastrointestinal malignancies, incidence has risen steadily by 2-3 percent a year over the past decade. Squamous cell carcinoma (SCC) is by far the most common type, accounting for over 90 percent of anal malignancies, and risk factors include female gender, Black race, and men who have sex with men (MSM). A well-defined relationship also exists between human papilloma virus (HPV) and squamous cell carcinoma of the anus, particularly HPV serotypes 16 and 18. Treatment of SCC of the anal canal includes chemotherapy, radiation, and/or surgical intervention. Depending on the initial staging, treatment may yield a five-year survival up to 89 percent. […] Treatment, survival, and quality of life vary with stage of disease and tumor location. The National Comprehensive Cancer Network guidelines recommend chemoradiation as first line treatment for stage I-III tumors. The standard radiation protocol generally follows a 30-45 Gy dose delivered over a 3.5-5 week period with a boost of an additional 5-24 Gy for most situations. These regimens present significant toxicity, which has led to increasing interest in alternative treatments to balance benefits and harms.

• #30 Molecular and Clinicopathologic Features Which Predict Outcome in Patients with Anorectal Melanoma | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-4020-9545-0_29

  Anorectal melanoma is a rare and lethal tumor associated with extremely poor prognosis. […] Even with aggressive surgical treatment, 80% will die of distant metastatic disease within 5 years. […] Observations regarding outcomes after surgical resection will also be reviewed, as will predictors of survival.

• #31 Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09729-4

  Few biomarkers have been identified as prognostic by more than one study: pre-treatment biopsy HPV load, as well as the presence of leukocytosis, neutrophilia and anaemia at baseline measurement. […] This systematic review confirms the following prognostic factors for outcomes following anal cancer treatment with conformal CRT: T stage, N stage, sex, pre-treatment biopsy HPV load, as well as the presence of baseline leukocytosis, neutrophilia and anaemia.

• #32 Treatment of Stage I-III Squamous Cell Anal Cancer | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/anal-cancer-treatment/protocol

  Although anal cancer only represents 1-2 percent of all gastrointestinal malignancies, incidence has risen steadily by 2-3 percent a year over the past decade. Squamous cell carcinoma (SCC) is by far the most common type, accounting for over 90 percent of anal malignancies, and risk factors include female gender, Black race, and men who have sex with men (MSM). A well-defined relationship also exists between human papilloma virus (HPV) and squamous cell carcinoma of the anus, particularly HPV serotypes 16 and 18. Treatment of SCC of the anal canal includes chemotherapy, radiation, and/or surgical intervention. Depending on the initial staging, treatment may yield a five-year survival up to 89 percent. […] Treatment, survival, and quality of life vary with stage of disease and tumor location. The National Comprehensive Cancer Network guidelines recommend chemoradiation as first line treatment for stage I-III tumors. The standard radiation protocol generally follows a 30-45 Gy dose delivered over a 3.5-5 week period with a boost of an additional 5-24 Gy for most situations. These regimens present significant toxicity, which has led to increasing interest in alternative treatments to balance benefits and harms.

• #33 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  A number of subsequent retrospective analyses have highlighted the potential prognostic utility of identifying tumour HPV involvement, either directly or through analysis of its surrogate marker, p16 overexpression. […] As shown in Table 1, OS, recurrence and both locoregional and systemic failure are reported to correlate with high p16 expression and the presence of HPV DNA. […] In multivariate analyses, HPV16 and p16 are both reported to be independently predictive of PFS and OS. […] The studies outlined here are retrospective and small. […] However, given that the majority of tumours are HPV positive […] additional biomarkers over and above HPV status are required to guide treatment stratification. […] The mutational profiling demonstrates differing routes to transformation (HPV) that appear to impact on clinical outcomes.

• #34 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  A number of subsequent retrospective analyses have highlighted the potential prognostic utility of identifying tumour HPV involvement, either directly or through analysis of its surrogate marker, p16 overexpression. […] As shown in Table 1, OS, recurrence and both locoregional and systemic failure are reported to correlate with high p16 expression and the presence of HPV DNA. […] In multivariate analyses, HPV16 and p16 are both reported to be independently predictive of PFS and OS. […] The studies outlined here are retrospective and small. […] However, given that the majority of tumours are HPV positive […] additional biomarkers over and above HPV status are required to guide treatment stratification. […] The mutational profiling demonstrates differing routes to transformation (HPV) that appear to impact on clinical outcomes.

• #35 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Cancer of the perianal skin tends to be diagnosed at an earlier stage, which also means it tends to have a better outlook. […] In a 2022 review of studies, researchers found that male sex and cancer spread to lymph nodes typically led to worse overall survival and a higher chance of treatment failure. […] People with a diagnosis of anal cancer at a younger age tend to have a better chance of survival than people who received a diagnosis at a later age. […] Most studies in the 2022 review of studies identified better performance status as a factor linked to a better outlook. […] In the 2022 review of studies, researchers found that lower detectable levels of HPV 16 were associated with a better outcome in 2 out of 3 of the studies they reviewed. […] Its well established that access to quality healthcare is linked to better outcomes in people with cancer due to improved time to diagnosis and treatment.

• #36 Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09729-4

  Few biomarkers have been identified as prognostic by more than one study: pre-treatment biopsy HPV load, as well as the presence of leukocytosis, neutrophilia and anaemia at baseline measurement. […] This systematic review confirms the following prognostic factors for outcomes following anal cancer treatment with conformal CRT: T stage, N stage, sex, pre-treatment biopsy HPV load, as well as the presence of baseline leukocytosis, neutrophilia and anaemia.

• #37 Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09729-4

  Few biomarkers have been identified as prognostic by more than one study: pre-treatment biopsy HPV load, as well as the presence of leukocytosis, neutrophilia and anaemia at baseline measurement. […] This systematic review confirms the following prognostic factors for outcomes following anal cancer treatment with conformal CRT: T stage, N stage, sex, pre-treatment biopsy HPV load, as well as the presence of baseline leukocytosis, neutrophilia and anaemia.

• #38 Prognostic factors for patients with anal cancer treated with conformal radiotherapy—a systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9164501/

  Anal cancer is primarily treated using concurrent chemoradiotherapy (CRT), with conformal techniques such as intensity modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) now being the standard techniques utilised across the world. […] Despite this, there is still very limited consensus on prognostic factors for outcome following conformal CRT. […] The results from 19 studies were analysed. In both univariable and multivariable analysis, N stage, T stage, and sex were found to be the most prevalent and reliable clinical prognostic factors for the majority of outcomes explored. […] Establishing a set of prognostic and potentially predictive factors for anal cancer outcomes can guide the risk stratification of patients, aiding the design of future clinical trials. […] This systematic review confirms the following prognostic factors for outcomes following anal cancer treatment with conformal CRT: T stage, N stage, sex, pre-treatment biopsy HPV load, as well as the presence of baseline leukocytosis, neutrophilia and anaemia.

• #39 FDG-PET metabolic response predicts outcomes in anal cancer managed with chemoradiotherapy | British Journal of Cancer

  https://www.nature.com/articles/bjc2011274

  FDG-PET metabolic response to chemoradiotherapy in anal cancer is significantly associated with PFS and OS, and in this cohort incomplete FDG-PET response was a stronger predictor than T or N stage. […] The 2-year progression-free survival (PFS) was 95% for patients with a CMR, 71% for PMR and 0% for NR (P0.0001). The 5-year overall survival (OS) was 88% in CMR, 69% in PMR and 0% in NR (P0.0001). […] For PFS, the only significant correlation was with incomplete metabolic response to treatment (partial or no response) vs no response (HR 4.1. (95% CI: 1.511.5,P=0.013; Table 3). Higher T and N stage were suggestive of worse prognosis but did not reach statistical significance in this patient cohort. In prediction of OS times, FDG-PET incomplete metabolic response was again the only variable to show significant evidence of an association (HR 6.7 (95% CI: 2.121.6, P=0.002)).

• #40 FDG-PET metabolic response predicts outcomes in anal cancer managed with chemoradiotherapy | British Journal of Cancer

  https://www.nature.com/articles/bjc2011274

  FDG-PET metabolic response to chemoradiotherapy in anal cancer is significantly associated with PFS and OS, and in this cohort incomplete FDG-PET response was a stronger predictor than T or N stage. […] The 2-year progression-free survival (PFS) was 95% for patients with a CMR, 71% for PMR and 0% for NR (P0.0001). The 5-year overall survival (OS) was 88% in CMR, 69% in PMR and 0% in NR (P0.0001). […] For PFS, the only significant correlation was with incomplete metabolic response to treatment (partial or no response) vs no response (HR 4.1. (95% CI: 1.511.5,P=0.013; Table 3). Higher T and N stage were suggestive of worse prognosis but did not reach statistical significance in this patient cohort. In prediction of OS times, FDG-PET incomplete metabolic response was again the only variable to show significant evidence of an association (HR 6.7 (95% CI: 2.121.6, P=0.002)).

• #41 Pre-treatment tumour PET metrics and clinical outcomes of anal cancer in patients living with and without HIV

  https://medicaljournalssweden.se/actaoncologica/article/download/40680/50006?inline=1

  Pre-treatment PET metrics predicted clinical outcomes for PLWH without VL, but not for PLWH with VL. […] This may be due to limited patient numbers in this cohort, making it difficult to assess a prognostic factors strength between groups with a large difference in patient number, or VL or immunogenic cancer-HIV interactions reducing PETs prognostic efficacy. […] MTV and TLG were significant risk factors in HIV-negative patients and PLWH, but appeared to not be significant when analysed in PLWH with active VL, although that group had a very limited sample size. […] Patients with ASCC had similar outcomes regardless of HIV status. […] Advanced pre-treatment PET metrics, especially MTV and TLG, demonstrated prognostic utility in HIV-negative patients and PLWH and undetectable VL with ASCC, but were not associated with clinical outcomes for PLWH with active VL, perhaps due to small numbers of patients or immunogenic factors that remain to be explored.

• #42 Treatment of Stage I-III Squamous Cell Anal Cancer | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/anal-cancer-treatment/protocol

  Although anal cancer only represents 1-2 percent of all gastrointestinal malignancies, incidence has risen steadily by 2-3 percent a year over the past decade. Squamous cell carcinoma (SCC) is by far the most common type, accounting for over 90 percent of anal malignancies, and risk factors include female gender, Black race, and men who have sex with men (MSM). A well-defined relationship also exists between human papilloma virus (HPV) and squamous cell carcinoma of the anus, particularly HPV serotypes 16 and 18. Treatment of SCC of the anal canal includes chemotherapy, radiation, and/or surgical intervention. Depending on the initial staging, treatment may yield a five-year survival up to 89 percent. […] Treatment, survival, and quality of life vary with stage of disease and tumor location. The National Comprehensive Cancer Network guidelines recommend chemoradiation as first line treatment for stage I-III tumors. The standard radiation protocol generally follows a 30-45 Gy dose delivered over a 3.5-5 week period with a boost of an additional 5-24 Gy for most situations. These regimens present significant toxicity, which has led to increasing interest in alternative treatments to balance benefits and harms.

• #43 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  Squamous cell carcinomas of the anus and anal canal represent a model of a cancer and perhaps the first where level 1 evidence supported primary chemoradiotherapy (CRT) in treating locoregional disease with curative intent. […] However, not all tumours are cured with CRT and there remain opportunities to improve outcomes in terms of oncological control and also reducing late toxicities. […] Understanding the biology of ASCC promises to allow a more personalised approach to treatment, with the development and validation of a range of biomarkers and associated techniques that are the focus of this review. […] Although data around late toxicity from anal cancer CRT is limited (Bentzen et al, 2013) up to 30% patients experience debilitating side effects, particularly in terms of bowel function.

• #44 Factors Influencing Outcomes and Survival in Anal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11431442/

  The following factors were associated with better survival on univariate analysis: complete response to dCRT HR = 0.058, (95% CI 0.0120.28, * p = 0.0001), negative nodal status HR = 0.29, (95% CI 1 0.110.82, * p = 0.02). The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.1312.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.1310.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.1122.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.2826.42, * p = 0.02) (Table 2). […] This study highlights the critical prognostic factors in anal cancer management, including tumour stage, nodal status, and histological differentiation.

• #45 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  In terms of utilising biomarkers to improve outcomes, first, factors that are predictive of response would facilitate modulation of components of CRT (i.e., radiotherapy dose or novel combination therapeutics) either aiming to improve response rates in poor risk disease, or potentially de-intensify treatment to avoid excessive late toxicity. […] There is considerable variation in radiotherapy doses used, from the relatively lower doses in the initial series (Nigro et al, 1983), through 50.4Gy in ACT2 to 5464Gy in the Nordic countries (Leon et al, 2014). […] A number of variables are reported to contribute to the heterogeneity in outcomes seen in patients with ASCC (Das et al, 2008). […] It has also been reported that initial response to treatment with radiotherapy correlates with the extent of both local control and OS.

• #46 Factors Influencing Outcomes and Survival in Anal Cancer

  https://www.mdpi.com/article/10.3390/curroncol31090381?type=check_update&version=1

  Factors Influencing Outcomes and Survival in Anal Cancer […] Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] The following factors were associated with better survival on univariate analysis: complete response to dCRT HR = 0.058, (95% CI 0.012–0.28, * p = 0.0001), negative nodal status HR = 0.29, (95% CI 1 0.11–0.82, * p = 0.02). The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] The 3-year OS for the entire cohort was 76.1%, reducing to 57.14% in those requiring salvage APR. […] Recurrence remains a significant challenge in the management of anal cancer, with 8% of patients experiencing local recurrence and 6.7% developing distant metastases. Our analysis showed that recurrence was a strong predictor of poor survival (p = 0.006), emphasising the need for vigilant post-treatment surveillance and potential adjuvant therapies to mitigate the risk of recurrence.

• #47 Factors Influencing Outcomes and Survival in Anal Cancer

  https://www.mdpi.com/article/10.3390/curroncol31090381?type=check_update&version=1

  Factors Influencing Outcomes and Survival in Anal Cancer […] Background: We aim to ascertain prognostic factors in the current management of anal cancer within this study. […] Adverse prognostic indicators include those with T4 disease hazard ratio = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having N2 nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] Presenting characteristics including stage, nodal, and differentiation status remain key prognostic indicators in those diagnosed with anal malignancy. […] The following factors were associated with better survival on univariate analysis: complete response to dCRT HR = 0.058, (95% CI 0.012–0.28, * p = 0.0001), negative nodal status HR = 0.29, (95% CI 1 0.11–0.82, * p = 0.02). The following factors were associated with poorer survival on univariate analysis: T4 disease HR = 3.81, (95% CI 1.13–12.83, * p = 0.04), poorly differentiated tumour disease HR = 3.37, (95% CI 1.13–10.02, * p = 0.04), having positive nodal status HR = 5.03, (95% CI 1.11–22.8, * p = 0.04), and having metastatic disease at diagnosis HR = 5.8, (95% CI 1.28–26.42, * p = 0.02). […] The 3-year OS for the entire cohort was 76.1%, reducing to 57.14% in those requiring salvage APR. […] Recurrence remains a significant challenge in the management of anal cancer, with 8% of patients experiencing local recurrence and 6.7% developing distant metastases. Our analysis showed that recurrence was a strong predictor of poor survival (p = 0.006), emphasising the need for vigilant post-treatment surveillance and potential adjuvant therapies to mitigate the risk of recurrence.

• #48 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Cancer of the perianal skin tends to be diagnosed at an earlier stage, which also means it tends to have a better outlook. […] In a 2022 review of studies, researchers found that male sex and cancer spread to lymph nodes typically led to worse overall survival and a higher chance of treatment failure. […] People with a diagnosis of anal cancer at a younger age tend to have a better chance of survival than people who received a diagnosis at a later age. […] Most studies in the 2022 review of studies identified better performance status as a factor linked to a better outlook. […] In the 2022 review of studies, researchers found that lower detectable levels of HPV 16 were associated with a better outcome in 2 out of 3 of the studies they reviewed. […] Its well established that access to quality healthcare is linked to better outcomes in people with cancer due to improved time to diagnosis and treatment.

• #49 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Cancer of the perianal skin tends to be diagnosed at an earlier stage, which also means it tends to have a better outlook. […] In a 2022 review of studies, researchers found that male sex and cancer spread to lymph nodes typically led to worse overall survival and a higher chance of treatment failure. […] People with a diagnosis of anal cancer at a younger age tend to have a better chance of survival than people who received a diagnosis at a later age. […] Most studies in the 2022 review of studies identified better performance status as a factor linked to a better outlook. […] In the 2022 review of studies, researchers found that lower detectable levels of HPV 16 were associated with a better outcome in 2 out of 3 of the studies they reviewed. […] Its well established that access to quality healthcare is linked to better outcomes in people with cancer due to improved time to diagnosis and treatment.

• #50 Anal Cancer: Symptoms, Causes, Diagnosis, and Treatment

  https://www.webmd.com/cancer/what-is-anal-cancer

  The American Cancer Society estimated that 10,540 cases of anal cancer will be diagnosed in 2024 and about 2,190 deaths may occur that year from anal cancer. […] Approximately half of all anal cancers are diagnosed before the malignancy has spread beyond the primary site, whereas 13% to 25% are diagnosed after the cancer has spread to the lymph nodes, and 10% are diagnosed after the cancer has spread to distant organs, or has metastasized. […] When it is found early, anal cancer is highly treatable. […] The overall five-year survival rate following diagnosis of anal cancer is 64%. […] Immunocompromised patients, such as those with HIV disease, are prone to get anal cancer. In this subgroup, the prognosis is worse than for non-immunocompromised patients.

• #51 Pre-treatment tumour PET metrics and clinical outcomes of anal cancer in patients living with and without HIV

  https://medicaljournalssweden.se/actaoncologica/article/download/40680/50006?inline=1

  Outcomes were comparable between HIV-negative patients and PLWH. […] Pre-treatment PET metrics were validated as significantly predicting outcomes for the entire cohort and HIV-negative patients, not PLWH. […] This may be from small numbers of PLWH patients, or non-specific uptake in patients with uncontrolled HIV reducing PETs prognostic efficacy. […] HIV infection induces lymphocyte glycolysis and PET-activation patterns indicative of viral load (VL) and HIV disease-state. […] Attempting to ascertain prognosis in ASCC patients living with HIV (PLWH) by PET metrics may be complicated by infection, VL, and HAART adherence, which is largely unexplored. […] There is conflicting data, with some studies showing PLWH and ASCC have worse outcomes than HIV-negative ASCC patients. […] Other studies have shown CRT is well-tolerated by PLWH and outcomes are similar to those for HIV-negative patients.

• #52 Pre-treatment tumour PET metrics and clinical outcomes of anal cancer in patients living with and without HIV

  https://medicaljournalssweden.se/actaoncologica/article/download/40680/50006?inline=1

  Pre-treatment PET metrics predicted clinical outcomes for PLWH without VL, but not for PLWH with VL. […] This may be due to limited patient numbers in this cohort, making it difficult to assess a prognostic factors strength between groups with a large difference in patient number, or VL or immunogenic cancer-HIV interactions reducing PETs prognostic efficacy. […] MTV and TLG were significant risk factors in HIV-negative patients and PLWH, but appeared to not be significant when analysed in PLWH with active VL, although that group had a very limited sample size. […] Patients with ASCC had similar outcomes regardless of HIV status. […] Advanced pre-treatment PET metrics, especially MTV and TLG, demonstrated prognostic utility in HIV-negative patients and PLWH and undetectable VL with ASCC, but were not associated with clinical outcomes for PLWH with active VL, perhaps due to small numbers of patients or immunogenic factors that remain to be explored.

• #53 Prognosis for Anal Cancer: Survival Rates and Influencing Factors

  https://www.healthline.com/health/cancer/prognosis-for-anal-cancer

  Cancer of the perianal skin tends to be diagnosed at an earlier stage, which also means it tends to have a better outlook. […] In a 2022 review of studies, researchers found that male sex and cancer spread to lymph nodes typically led to worse overall survival and a higher chance of treatment failure. […] People with a diagnosis of anal cancer at a younger age tend to have a better chance of survival than people who received a diagnosis at a later age. […] Most studies in the 2022 review of studies identified better performance status as a factor linked to a better outlook. […] In the 2022 review of studies, researchers found that lower detectable levels of HPV 16 were associated with a better outcome in 2 out of 3 of the studies they reviewed. […] Its well established that access to quality healthcare is linked to better outcomes in people with cancer due to improved time to diagnosis and treatment.

• #54 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  Squamous cell carcinomas of the anus and anal canal represent a model of a cancer and perhaps the first where level 1 evidence supported primary chemoradiotherapy (CRT) in treating locoregional disease with curative intent. […] However, not all tumours are cured with CRT and there remain opportunities to improve outcomes in terms of oncological control and also reducing late toxicities. […] Understanding the biology of ASCC promises to allow a more personalised approach to treatment, with the development and validation of a range of biomarkers and associated techniques that are the focus of this review. […] Although data around late toxicity from anal cancer CRT is limited (Bentzen et al, 2013) up to 30% patients experience debilitating side effects, particularly in terms of bowel function.

• #55 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  Importantly, from a mechanistic perspective, these cohorts included patients with HNSCC treated with surgery, suggesting a prognostic effect of both HPV status and TIL across treatment modalities (and hence not simply related to sensitivity to CRT through TP53 mutations as discussed earlier). […] This finding requires validation in a cohort of samples large enough for robust multivariate analysis to include all clinical and radiological factors but raises the possibility that modulating the host response to the tumour could improve therapeutic response. […] Predictive markers that allow real time analysis (and may be prospectively compared with imaging results) would be of significant clinical benefit. […] More recently there has been interest in SCCA in follow up where one small study of 24 patients was not consistent with respect to baseline prognosis, but during follow up, 2 patients demonstrated a rise of SCCA, one of whom developed recurrence and metastatic disease. […] The clinical trial platforms currently being developed can then be adapted to test these approaches as studies and data progress. […] Our current understanding of prognostic biomarkers offers insights into how biological factors mediate disease progression and response.

• #56 Biomarkers in anal cancer: from biological understanding to stratified treatment | British Journal of Cancer

  https://www.nature.com/articles/bjc2016398

  In terms of utilising biomarkers to improve outcomes, first, factors that are predictive of response would facilitate modulation of components of CRT (i.e., radiotherapy dose or novel combination therapeutics) either aiming to improve response rates in poor risk disease, or potentially de-intensify treatment to avoid excessive late toxicity. […] There is considerable variation in radiotherapy doses used, from the relatively lower doses in the initial series (Nigro et al, 1983), through 50.4Gy in ACT2 to 5464Gy in the Nordic countries (Leon et al, 2014). […] A number of variables are reported to contribute to the heterogeneity in outcomes seen in patients with ASCC (Das et al, 2008). […] It has also been reported that initial response to treatment with radiotherapy correlates with the extent of both local control and OS.

• #57 Survival statistics for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/prognosis-and-survival/survival-statistics

  People with cancer should talk to their doctor about their prognosis. Prognosis depends on many factors, including; your health history, type of cancer, stage, characteristics of the cancer, treatments chosen, response to treatment. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

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