ESTRO 2022

Session Item

Saturday

May 07

16:55 - 17:55

Room D3

Lower GI

Co-Chair: , France;

Chair: , Italy

Session Code: 1500

Session Type: Proffered Papers

Track: Clinical

17:15 - 17:25

Final results of the French national cohort ANABASE : treatment and outcome in anal cancer

Véronique Vendrely, France

Presentation Number: OC-0270

Abstract

Abstract Title:

Final results of the French national cohort ANABASE : treatment and outcome in anal cancer

Authors:

Véronique Vendrely¹, Claire LEMANSKI², Pascal POMMIER³, Karine LE MALICOT⁴, Eric FRANCOIS⁵, Eleonor RIVIN DEL CAMPO⁶, Pauline REGNAULT⁷, Nabil BABA-HAMED⁸, Philippe RONCHIN⁹, Gilles CREHANGE¹⁰, David TOUGERON¹¹, Elodie MENAGER-TABOUREL¹², Olivia DIAZ¹³, Michael HUMMELSBERGER¹⁴, Anne DE LA ROCHEFORDIERE¹⁵, Côme LEPAGE¹⁶, Laurent QUERO¹⁷

¹CHU Bordeaux, Oncology radiotherapy, BORDEAUX, France; ²Val d'Aurelle Cancer Center, Radiotherapy, Montpellier, France; ³Léon Bérard Cancer Center, Radiotherapy, LYON, France; ⁴Fédération Francophone de Cancérologie Digestive, university of Burgundy, Biostatistics, Dijon, France; ⁵Antoine Lacassagne Cancer Center, Oncology, Nice, France; ⁶APHP, Tenon Hospital, Radiotherapy, Paris, France; ⁷Tivoli Clinic, Radiotherapy, Bordeaux, France; ⁸Saint-Joseph Hospital group, Oncology Department, Paris, France; ⁹Azuréen Cancer Center, Radiotherapy, Mougins, France; ¹⁰Georges François Leclerc cancer center, radiotherapy, Dijon, France; ¹¹CHU Poitiers, Medical Oncology, Poitiers, France; ¹²Derpartemental Hospital of Vendee, Medical Oncology, La Roche sur Yon, France; ¹³Daniel Hollard Institute, Radiotherapy, Grenoble, France; ¹⁴Radiotherapy and medical oncology center, Radiotherapy, Béziers, France; ¹⁵Institut Curie, Medical Oncology, Paris, France; ¹⁶EPICAD INSERM LNC-UMR 1231, University of Burgundy, gastro-enterology, Dijon, France; ¹⁷St Louis Hospital, APHP, Radiotherapy, Paris, France

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Purpose or Objective

Evaluation of clinical practice, treatment and outcome after treatment of squamous cell carcinoma of the anus (SCCA) in the French national cohort ANABASE.

Material and Methods

This prospective national multicentric observational cohort included all patients (pts) treated for SCCA in 60 French centers from January 2015 to April 2020. Pts were treated according to French guidelines and local expertise of each center. Pts and tumor characteristics, treatments (chemotherapy (CT), radiotherapy (RT), and surgery) and outcomes were analyzed as well as colostomy-free, disease-free and overall survivals at 3 years. Univariate and multivariate analyses were performed by logistic regression in order to determine factors associated with survival.

Results

Among 1097 pts treated for a non-metastatic SCCA, 1015 pts with complete data were analyzed. Pts characteristics were as follow: median age: 65 years (range 32-94); gender: 248 males (24.4%) and 767 females (75.7%); HIV serology: positive 86 pts (17.6%), negative 402 (82.4%), among 488 pts with known status. Tumors were classified as locally limited (T0-1-2, N0, M0) for 440 pts (43.3%) and locally advanced (T3-4 or N+, M0) for 575 pts (56.7%). Regarding RT treatment, IMRT was used for 80.2% versus 3D for 19.8% of pts. Median total dose was 60 Gy (range 18-79), 150 pts had a brachytherapy boost. An interruption of treatment was made for 327 pts (32.2%), with a median duration of 14 days, because of toxicity in 47.4% of cases but mostly as planned gap in 52.6 % of cases. A concomitant CT was administered for 803 pts, including mitomycin-based CT for 86.2%, cisplatin-based CT for 3.6% and 5FU alone for 4.4%. An induction CT before RCT was administered for 70 pts (6.9%). Median follow-up was 35.5 months [IC 95%: 34.4;36.0].

Overall survival, disease-free and colostomy-free survival at 3 years were 91.7% [95%CI: 88.0-94.2], 84.3% [95%CI: 80.1; 87.8] and 85.8% [95%CI: 81.6; 89.1] respectively for pts with locally limited tumors (T0-1-2, N0, M0) compared to 78.2% [95%CI: 73.6-82.1], 64.4 % [IC95% : 59.7; 68.7] and 67.3 % [IC95% : 62.5; 71.6] respectively for pts with locally advanced (T3-4 or N+, M0). Patient gender (male), OMS condition, HIV positive status and locally advanced tumors were significantly associated with poor DFS and CFS in multivariate analysis. Only male gender, HIV positive status and OMS condition were associated with OS. A specific complementary analysis was done for HIV patients.

A recurrence occurred in 202 patients: local or nodal in the pelvis for 115 pts (56.9%), metastatic for 72 pts (35.6%) or both for 12 pts (5.9%). Salvage surgery (abdomino-perineal resection) was done for 90 pts.

Conclusion

Final results of the ANABASE cohort showed a good accordance with actual guidelines for anal cancer treatment with the use of IMRT treatments and mitomycin-based chemotherapy for more than 80% of pts. An improvement in the management of SCCA is mandatory for HIV-positive pts and pts presenting with locally advanced tumors.