Nomogram for Predicting Overall Survival and Salvage Abdominoperineal Resection for Patients with Anal Cancer

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4 Citations (Scopus)

Abstract

Anal cancer treatment has evolved from abdominoperineal resection to chemoradiotherapy, which allows for sphincter preservation. OBJECTIVE: The aim of this study was to develop an accurate model and nomogram to predict overall survival and the probability of salvage abdominoperineal resection for anal cancer patients. DESIGN: This is a retrospective cohort study. SETTINGS: Data were gathered from National Cancer Database entries from 1998 to 2010. PATIENTS: Patients with de novo anal cancer were selected from the National Cancer Database in the years 1998 through 2010; 1778 patients were included, and their data were analyzed. MAIN OUTCOME MEASURES: Variables included time to death, censoring indicator, age, race, sex, tumor size, year of diagnosis, surgery status, nodal status, TNM stage, and chemoradiation therapy. A stratified Cox proportional hazards model for overall survival and a logistic regression model for salvage abdominoperineal resection were developed. Our final models were internally validated for discrimination and validation. RESULTS: Statistically significant variables in the salvage surgery model were tumor size and nodal status (p ≤ 0.001). For overall survival model, statistically significant variables (all with p ≤ 0.005), fitted across the strata of TNM clinical stage included age, sex, tumor size, nodal status, chemoradiotherapy treatment, and combination salvage surgery and chemoradiotherapy. Nomograms that predict events are based on our final models. LIMITATIONS: Limitations included clerical database errors and nonmeasured variables, such as HIV status. CONCLUSIONS: A nomogram can predict overall survival and salvage surgery for an individual with anal cancer. Such tools may be used as decision support aids to guide therapy and predict whether or not patients may need salvage surgery.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalDiseases of the Colon and Rectum
Volume59
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Anus Neoplasms
Nomograms
Chemoradiotherapy
Survival
Databases
Neoplasms
Logistic Models
Salvage Therapy
Decision Support Techniques
Proportional Hazards Models
Cohort Studies
Therapeutics
Retrospective Studies
HIV

Keywords

  • Abdominoperineal resection
  • Anal cancer
  • Combined modality treatment
  • Nomogram
  • Surgical salvage
  • Survival

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Nomogram for Predicting Overall Survival and Salvage Abdominoperineal Resection for Patients with Anal Cancer",
abstract = "Anal cancer treatment has evolved from abdominoperineal resection to chemoradiotherapy, which allows for sphincter preservation. OBJECTIVE: The aim of this study was to develop an accurate model and nomogram to predict overall survival and the probability of salvage abdominoperineal resection for anal cancer patients. DESIGN: This is a retrospective cohort study. SETTINGS: Data were gathered from National Cancer Database entries from 1998 to 2010. PATIENTS: Patients with de novo anal cancer were selected from the National Cancer Database in the years 1998 through 2010; 1778 patients were included, and their data were analyzed. MAIN OUTCOME MEASURES: Variables included time to death, censoring indicator, age, race, sex, tumor size, year of diagnosis, surgery status, nodal status, TNM stage, and chemoradiation therapy. A stratified Cox proportional hazards model for overall survival and a logistic regression model for salvage abdominoperineal resection were developed. Our final models were internally validated for discrimination and validation. RESULTS: Statistically significant variables in the salvage surgery model were tumor size and nodal status (p ≤ 0.001). For overall survival model, statistically significant variables (all with p ≤ 0.005), fitted across the strata of TNM clinical stage included age, sex, tumor size, nodal status, chemoradiotherapy treatment, and combination salvage surgery and chemoradiotherapy. Nomograms that predict events are based on our final models. LIMITATIONS: Limitations included clerical database errors and nonmeasured variables, such as HIV status. CONCLUSIONS: A nomogram can predict overall survival and salvage surgery for an individual with anal cancer. Such tools may be used as decision support aids to guide therapy and predict whether or not patients may need salvage surgery.",
keywords = "Abdominoperineal resection, Anal cancer, Combined modality treatment, Nomogram, Surgical salvage, Survival",
author = "Vassiliki Tsikitis and Kim Lu and Kim, {Jong S.} and Kevin Billingsley and Charles Thomas and Daniel Herzig",
year = "2016",
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language = "English (US)",
volume = "59",
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T1 - Nomogram for Predicting Overall Survival and Salvage Abdominoperineal Resection for Patients with Anal Cancer

AU - Tsikitis, Vassiliki

AU - Lu, Kim

AU - Kim, Jong S.

AU - Billingsley, Kevin

AU - Thomas, Charles

AU - Herzig, Daniel

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N2 - Anal cancer treatment has evolved from abdominoperineal resection to chemoradiotherapy, which allows for sphincter preservation. OBJECTIVE: The aim of this study was to develop an accurate model and nomogram to predict overall survival and the probability of salvage abdominoperineal resection for anal cancer patients. DESIGN: This is a retrospective cohort study. SETTINGS: Data were gathered from National Cancer Database entries from 1998 to 2010. PATIENTS: Patients with de novo anal cancer were selected from the National Cancer Database in the years 1998 through 2010; 1778 patients were included, and their data were analyzed. MAIN OUTCOME MEASURES: Variables included time to death, censoring indicator, age, race, sex, tumor size, year of diagnosis, surgery status, nodal status, TNM stage, and chemoradiation therapy. A stratified Cox proportional hazards model for overall survival and a logistic regression model for salvage abdominoperineal resection were developed. Our final models were internally validated for discrimination and validation. RESULTS: Statistically significant variables in the salvage surgery model were tumor size and nodal status (p ≤ 0.001). For overall survival model, statistically significant variables (all with p ≤ 0.005), fitted across the strata of TNM clinical stage included age, sex, tumor size, nodal status, chemoradiotherapy treatment, and combination salvage surgery and chemoradiotherapy. Nomograms that predict events are based on our final models. LIMITATIONS: Limitations included clerical database errors and nonmeasured variables, such as HIV status. CONCLUSIONS: A nomogram can predict overall survival and salvage surgery for an individual with anal cancer. Such tools may be used as decision support aids to guide therapy and predict whether or not patients may need salvage surgery.

AB - Anal cancer treatment has evolved from abdominoperineal resection to chemoradiotherapy, which allows for sphincter preservation. OBJECTIVE: The aim of this study was to develop an accurate model and nomogram to predict overall survival and the probability of salvage abdominoperineal resection for anal cancer patients. DESIGN: This is a retrospective cohort study. SETTINGS: Data were gathered from National Cancer Database entries from 1998 to 2010. PATIENTS: Patients with de novo anal cancer were selected from the National Cancer Database in the years 1998 through 2010; 1778 patients were included, and their data were analyzed. MAIN OUTCOME MEASURES: Variables included time to death, censoring indicator, age, race, sex, tumor size, year of diagnosis, surgery status, nodal status, TNM stage, and chemoradiation therapy. A stratified Cox proportional hazards model for overall survival and a logistic regression model for salvage abdominoperineal resection were developed. Our final models were internally validated for discrimination and validation. RESULTS: Statistically significant variables in the salvage surgery model were tumor size and nodal status (p ≤ 0.001). For overall survival model, statistically significant variables (all with p ≤ 0.005), fitted across the strata of TNM clinical stage included age, sex, tumor size, nodal status, chemoradiotherapy treatment, and combination salvage surgery and chemoradiotherapy. Nomograms that predict events are based on our final models. LIMITATIONS: Limitations included clerical database errors and nonmeasured variables, such as HIV status. CONCLUSIONS: A nomogram can predict overall survival and salvage surgery for an individual with anal cancer. Such tools may be used as decision support aids to guide therapy and predict whether or not patients may need salvage surgery.

KW - Abdominoperineal resection

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KW - Combined modality treatment

KW - Nomogram

KW - Surgical salvage

KW - Survival

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