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COMPARISON OF OUTCOMES IN ANAL AND RECTAL ADENOCARCINOMA: AN ANALYSIS OF THE NATIONAL CANCER DATA BASE
Allison McCurdy
*, Gabriel Akopian, Howard Kaufman
Huntington Health, Pasadena, CA
ObjectiveTo evaluate differences in treatment patterns and outcomes for patients with anal (AA) and rectal (RA) adenocarcinoma.
BackgroundThe treatment of AA is modeled from RA. There is still a paucity of information comparing outcomes using a large national database.
MethodsData were analyzed from the National Cancer Database Participant User File for adult patients with stage I-III AA and RA who underwent abdominoperineal resection or total proctectomy between 2004 and 2020. Comparisons were made using Chi squared and Mann Whitney U tests. Kaplan-Meier survival analysis was performed.
OutcomePrimary outcome was overall survival (OS).
ResultsA total of 28,590 (97%) had RA and 766 (3%) had AA. Median age at diagnosis was 64 years, and 63% were male. Patients with AA had worse OS compared to RA (73 vs 104 months; p<0.001).
Patients with RA were more likely to receive chemotherapy (78% vs 70%; p<0.001) and radiation therapy (75% vs 67%; p<0.001).
However in stage II disease, RA carried worse OS compared to AA if no additional therapy was given. If no chemotherapy was given, OS was 75 months for AA and 52 months for RA (p=0.01). If no radiation therapy was given, OS was 85 months for AA and 59 months for RA.
ConclusionsAA carries a worse OS and lower rate of treatment with chemotherapy and radiation therapy compared with RA. However in stage II, RA carries a worse outcome if no chemotherapy or radiation therapy is used.
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