Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11)

Jaffer A. Ajani, Kathryn A. Winter, Leonard L. Gunderson, John Pedersen, Al B. Benson, Charles R. Thomas, Robert J. Mayer, Michael Haddock, Tyvin A. Rich, Christopher G. Willett

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30% at 3 years compared with 74% for the best group; <5 cm primary and N0) and OS (only 48% at 4 years compared with 81% for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.

Original languageEnglish (US)
Pages (from-to)4007-4013
Number of pages7
JournalCancer
Volume116
Issue number17
DOIs
StatePublished - Sep 1 2010

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Anus Neoplasms
Disease-Free Survival
Databases
Survival
Neoplasms
Statistical Factor Analysis
Multivariate Analysis

Keywords

  • Anal cancer
  • Clinical biology
  • Prognostic factors
  • Prospective database
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Ajani, J. A., Winter, K. A., Gunderson, L. L., Pedersen, J., Benson, A. B., Thomas, C. R., ... Willett, C. G. (2010). Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11). Cancer, 116(17), 4007-4013. https://doi.org/10.1002/cncr.25188

Prognostic factors derived from a prospective database dictate clinical biology of anal cancer : The intergroup trial (RTOG 98-11). / Ajani, Jaffer A.; Winter, Kathryn A.; Gunderson, Leonard L.; Pedersen, John; Benson, Al B.; Thomas, Charles R.; Mayer, Robert J.; Haddock, Michael; Rich, Tyvin A.; Willett, Christopher G.

In: Cancer, Vol. 116, No. 17, 01.09.2010, p. 4007-4013.

Research output: Contribution to journalArticle

Ajani, JA, Winter, KA, Gunderson, LL, Pedersen, J, Benson, AB, Thomas, CR, Mayer, RJ, Haddock, M, Rich, TA & Willett, CG 2010, 'Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: The intergroup trial (RTOG 98-11)', Cancer, vol. 116, no. 17, pp. 4007-4013. https://doi.org/10.1002/cncr.25188
Ajani, Jaffer A. ; Winter, Kathryn A. ; Gunderson, Leonard L. ; Pedersen, John ; Benson, Al B. ; Thomas, Charles R. ; Mayer, Robert J. ; Haddock, Michael ; Rich, Tyvin A. ; Willett, Christopher G. / Prognostic factors derived from a prospective database dictate clinical biology of anal cancer : The intergroup trial (RTOG 98-11). In: Cancer. 2010 ; Vol. 116, No. 17. pp. 4007-4013.
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abstract = "BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30{\%} at 3 years compared with 74{\%} for the best group; <5 cm primary and N0) and OS (only 48{\%} at 4 years compared with 81{\%} for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.",
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T1 - Prognostic factors derived from a prospective database dictate clinical biology of anal cancer

T2 - The intergroup trial (RTOG 98-11)

AU - Ajani, Jaffer A.

AU - Winter, Kathryn A.

AU - Gunderson, Leonard L.

AU - Pedersen, John

AU - Benson, Al B.

AU - Thomas, Charles R.

AU - Mayer, Robert J.

AU - Haddock, Michael

AU - Rich, Tyvin A.

AU - Willett, Christopher G.

PY - 2010/9/1

Y1 - 2010/9/1

N2 - BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30% at 3 years compared with 74% for the best group; <5 cm primary and N0) and OS (only 48% at 4 years compared with 81% for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.

AB - BACKGROUND: Only 4 prospective randomized phase 3 trials have been reported for anal cancer. A prognostic factor analysis for anal cancer from a prospective database has been published from only 1 study (N = 110). To confirm and uncover new prognostic factors,we analyzed the prospective database of intergroup RTOG 98-11. METHODS: Univariate and multivariate analyses of the baseline characteristics for 5-year overall survival (OS) and disease-free survival (DFS) were carried out. Various combinations of tumor diameter and clinically positive nodes (N+) were analyzed to identify subgroups. RESULTS: A total of 644 were assessable and analyzed. Tumor diameter >5 cm was associated with poorer 5-year DFS (P = .0003) and poorer 5-year OS (P = .0031), and N+ was associated with poorer 5-year DFS (P ≤ .0001) and poorer 5-year OS (P = ≤ .0001) in the multivariate analysis. In stratified analyses, N+ had more adverse influence on DFS and OS than did tumor diameter. Patients with >5-cm tumor and N+ had the worst DFS (only 30% at 3 years compared with 74% for the best group; <5 cm primary and N0) and OS (only 48% at 4 years compared with 81% for the best group; <5 cm primary and N0). Men had worse DFS (P = .02) and OS (P = .016). These factors maintained their influence in each treatment arm. CONCLUSIONS: This prospective prognostic factor analysis establishes tumor diameter as an independent prognosticator of poorer 5-year DFS and OS and confirms N + and male sex as poor prognostic factors. This analysis also uncovers novel subgroups (derived from combining prognostic factors) with incremental worsening of DFS and OS.

KW - Anal cancer

KW - Clinical biology

KW - Prognostic factors

KW - Prospective database

KW - Survival

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