Development and Validation of Prognostic Survival Nomograms for Patients with Anal Canal Cancer: A SEER-Based Study

Tang, Jie; Zhu, Lin; Huang, Yuejiao; Yang, Lixiang; Ge, Dangen; Hu, Zhengyu; Wang, Chun

doi:10.2147/ijgm.s346381

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…26-28 The creation of predictive nomograms has yielded promising outcomes in forecasting cancer-specific and overall survival rates, as well as aiding risk assessment; however, it is crucial to acknowledge that these nomograms have been exclusively grounded in clinical data. 29-31 Notably, the promise of radiomics features extracted from medical imaging, introducing the potential for supplementary insightful data. The amalgamation of these novel parameters with pre-existing clinical factors appears to augment performance.…”

Section: Discussionmentioning

confidence: 99%

Radiomics; Contemporary Applications in the Management of Anal Cancer; A Systematic Review

Temperley,

O’Sullivan,

Waters

et al. 2023

The American Surgeon™

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Introduction The management of anal cancer relies on clinical and histopathological features for treatment decisions. In recent years, the field of radiomics, which involves the extraction and analysis of quantitative imaging features, has shown promise in improving management of pelvic cancers. The aim of this study was to evaluate the current application of radiomics in the management of anal cancer. Methods A systematic search was conducted in Medline, EMBASE, and Web of Science databases. Inclusion criteria encompassed randomized and non-randomized trials investigating the use of radiomics to predict post-operative recurrence in anal cancer. Study quality was assessed using the QUADAS-2 and Radiomics Quality Score tools. Results The systematic review identified a total of nine studies, with 589 patients examined. There were three main outcomes assessed in included studies: recurrence (6 studies), progression-free survival (2 studies), and prediction of human papillomavirus (HPV) status (1 study). Radiomics-based risk stratification models were found to provide valuable insights into treatment response and patient outcomes, with all developed signatures demonstrating at least modest accuracy (range: .68-1.0) in predicting their primary outcome. Conclusion Radiomics has emerged as a promising tool in the management of anal cancer. It offers the potential for improved risk stratification, treatment planning, and response assessment, thereby guiding personalized therapeutic approaches.

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Section: Discussionmentioning

confidence: 99%

Radiomics; Contemporary Applications in the Management of Anal Cancer; A Systematic Review

Temperley,

O’Sullivan,

Waters

et al. 2023

The American Surgeon™

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Comparison of the TNM9th and 8th editions for localized and locally advanced anal squamous cell carcinoma treated nonsurgically and proposal of a new stage grouping system

Zheng,

Wang,

et al. 2024

Cancer Medicine

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ObjectiveTo compare the survival discrimination of the TNM9th and 8th editions for localized and locally advanced anal squamous cell carcinoma (ASCC) treated nonsurgically and suggest a simple revised staging system with data from the Surveillance, Epidemiology, and End Results (SEER) database.MethodsOverall survival (OS) was the primary endpoint. Survival comparisons between the T and N stages and the different staging systems were performed using the Kaplan–Meier method and log‐rank test, followed by correlation analysis and variable importance analysis (VIA). Additionally, multivariate analysis was employed to identify significant predictors, which were further visualized using a nomogram. Finally, calibration curve, C‐index, and decision curve analysis (DCA) were applied to assess the performance of the different staging systems.ResultsA total of 5384 patients with ASCC were analyzed, revealing superior discrimination OS by the TNM9th edition compared to that by the TNM8th edition. Multivariate analysis identified the T and N stages as significant OS predictors (all p < 0.001). However, ambiguity persisted in stage III subgroups within the TNM9th edition, showing OS times of 102 months for stage IIIA disease, 88 months for stage IIIB disease, and 128 months for stage IIIC disease (all p > 0.05). Correlation analysis demonstrated an increased correlation for the T stage between the TNM8th and 9th editions (ρ value from 0.7 to 0.89), while the N stage correlation decreased (ρ value from 0.84 to 0.56). VIA and the prognostic nomogram highlighted the greater importance of the T stage over the N stage. Based on these findings, a new staging system was developed, and its clinical utility was confirmed through calibration curves, C‐index values (from 0.598 to 0.604), and DCAs.ConclusionsOur new staging system exhibited slightly better prognostic value compared to the TNM9th staging systems for nonmetastatic ASCC and warrants further validation.

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Treatment of stage I-III squamous cell anal cancer: a comparative effectiveness systematic review

Troester,

Parikh,

Southwell

et al. 2024

JNCI: Journal of the National Cancer Institute

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Purpose To assess the effectiveness and harms of initial treatment strategies for stages I-III anal squamous cell cancer (SCC). Methods We searched Medline®, Embase®, and CENTRAL®, between January 1, 2000- March 2024, for randomized controlled trials and nonrandomized studies of interventions comparing initial treatment strategies. Individual study risk of bias (RoB) and overall strength of evidence (SOE) were evaluated for a prespecified outcome list using standardized methods. Results We identified 33 eligible studies and extracted data. Six were deemed low/moderate RoB. Compared with radiotherapy (RT) alone, chemoradiotherapy (CRT) with 5-fluorouracil (FU) and mitomycin C (MMC) probably shows a benefit in locoregional failure (LRF), disease-specific (DSS), and colostomy-free survival (CFS) (moderate SOE) yet may result in greater overall and acute hematologic toxicity, with no difference in late harms (low SOE). CRT with 5FU+MMC may show a benefit in LRF, DSS, and CFS rates compared with 5FU alone (low SOE). CRT with 5FU+cisplatin vs 5FU+MMC probably results in no differences in several effectiveness outcomes or overall acute or late harms, and probably increases hematologic toxicity with MMC (moderate SOE). Compared with CRT using capecitabine+MMC, CRT with capecitabine+MMC+paclitaxel may improve OS, DSS, and CFS, yet cause more acute harms (low SOE). Evidence was insufficient for remaining comparisons. Conclusions CRT with 5FU+MMC or 5FU+cisplatin is likely more effective yet incurs greater acute hematologic toxicity than RT alone or single-agent CRT. Adding paclitaxel to capecitabine+MMC may increase treatment efficacy and toxicity. Evidence is insufficient comparing post-treatment surveillance strategies and patient-reported outcomes, highlighting research opportunities.

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Development and Validation of Prognostic Survival Nomograms for Patients with Anal Canal Cancer: A SEER-Based Study

Cited by 3 publications

References 35 publications

Radiomics; Contemporary Applications in the Management of Anal Cancer; A Systematic Review

Radiomics; Contemporary Applications in the Management of Anal Cancer; A Systematic Review

Comparison of the TNM9th and 8th editions for localized and locally advanced anal squamous cell carcinoma treated nonsurgically and proposal of a new stage grouping system

Treatment of stage I-III squamous cell anal cancer: a comparative effectiveness systematic review

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