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US intergroup anal carcinoma trial: tumor diameter predicts for colostomy.

Publication ,  Journal Article
Ajani, JA; Winter, KA; Gunderson, LL; Pedersen, J; Benson, AB; Thomas, CR; Mayer, RJ; Haddock, MG; Rich, TA; Willett, CG
Published in: J Clin Oncol
March 1, 2009

PURPOSE: The US Gastrointestinal Intergroup Radiation Therapy Oncology Group 98-11 anal carcinoma trial showed that cisplatin-based concurrent chemoradiotherapy resulted in a significantly higher rate of colostomy compared with mitomycin-based therapy. Established prognostic variables for patients with anal carcinoma include tumor diameter, clinical nodal status, and sex, but pretreatment variables that would predict the likelihood of colostomy are unknown. METHODS: A secondary analysis was performed by combining patients in the two treatment arms to evaluate whether new predictive and prognostic variables would emerge. Univariate and multivariate analyses were carried out to correlate overall survival (OS), disease-free survival, and time to colostomy (TTC) with pretreatment and treatment variables. RESULTS: Of 682 patients enrolled, 644 patients were assessable and analyzed. In the multivariate analysis, tumor-related prognosticators for poorer OS included node-positive cancer (P < or = .0001), large (> 5 cm) tumor diameter (P = .01), and male sex (P = .016). In the treatment-related categories, cisplatin-based therapy was statistically significantly associated with a higher rate of colostomy (P = .03) than was mitomycin-based therapy. In the pretreatment variables category, only large tumor diameter independently predicted for TTC (P = .008). Similarly, the cumulative 5-year colostomy rate was statistically significantly higher for large tumor diameter than for small tumor diameter (Gray's test; P = .0074). Clinical nodal status and sex were not predictive of TTC. CONCLUSION: The combined analysis of the two arms of RTOG 98-11, representing the largest prospective database, reveals that tumor diameter (irrespective of the nodal status) is the only independent pretreatment variable that predicts TTC and 5-year colostomy rate in patients with anal carcinoma.

Duke Scholars

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

March 1, 2009

Volume

27

Issue

7

Start / End Page

1116 / 1121

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Analysis
  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Prognosis
  • Oncology & Carcinogenesis
  • Multivariate Analysis
  • Mitomycin
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ajani, J. A., Winter, K. A., Gunderson, L. L., Pedersen, J., Benson, A. B., Thomas, C. R., … Willett, C. G. (2009). US intergroup anal carcinoma trial: tumor diameter predicts for colostomy. J Clin Oncol, 27(7), 1116–1121. https://doi.org/10.1200/JCO.2008.19.6857
Ajani, Jaffer A., Kathryn A. Winter, Leonard L. Gunderson, John Pedersen, Al B. Benson, Charles R. Thomas, Robert J. Mayer, Michael G. Haddock, Tyvin A. Rich, and Christopher G. Willett. “US intergroup anal carcinoma trial: tumor diameter predicts for colostomy.J Clin Oncol 27, no. 7 (March 1, 2009): 1116–21. https://doi.org/10.1200/JCO.2008.19.6857.
Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB, Thomas CR, et al. US intergroup anal carcinoma trial: tumor diameter predicts for colostomy. J Clin Oncol. 2009 Mar 1;27(7):1116–21.
Ajani, Jaffer A., et al. “US intergroup anal carcinoma trial: tumor diameter predicts for colostomy.J Clin Oncol, vol. 27, no. 7, Mar. 2009, pp. 1116–21. Pubmed, doi:10.1200/JCO.2008.19.6857.
Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB, Thomas CR, Mayer RJ, Haddock MG, Rich TA, Willett CG. US intergroup anal carcinoma trial: tumor diameter predicts for colostomy. J Clin Oncol. 2009 Mar 1;27(7):1116–1121.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

March 1, 2009

Volume

27

Issue

7

Start / End Page

1116 / 1121

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Analysis
  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Prognosis
  • Oncology & Carcinogenesis
  • Multivariate Analysis
  • Mitomycin
  • Male
  • Humans