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Outcomes in immunosuppressed anal cancer patients.

Authors
  • Bingmer, Katherine1
  • Ofshteyn, Asya1
  • Dietz, David W1
  • Stein, Sharon L1
  • Steinhagen, Emily2
  • 1 University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES), Department of Surgery, University Hospitals, Cleveland Medical Center, Cleveland, OH, USA.
  • 2 University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES), Department of Surgery, University Hospitals, Cleveland Medical Center, Cleveland, OH, USA. Electronic address: [email protected]
Type
Published Article
Journal
American journal of surgery
Publication Date
Jan 01, 2020
Volume
219
Issue
1
Pages
88–92
Identifiers
DOI: 10.1016/j.amjsurg.2019.08.011
PMID: 31477240
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. 19 (14%) of 136 anal cancer patients were immunosuppressed. Immunosuppressed patients were more likely to be hypoalbuminemic (21% vs. 6%, p = 0.025), less likely to complete chemotherapy (58% vs. 80%, p = 0.031) or exhibit a complete response to chemoradiation (57% vs. 82%, p = 0.037), and more likely to experience recurrence (53% vs. 25%, p = 0.013). Hypoalbuminemia was significantly associated with worse overall (HR 6.4, CI 2.2-19.2, p < 0.001) and progression-free (HR 4.4, CI 1.8-10.4, p < 0.001) survival. Immunosuppressed patients have poor tolerance of chemotherapy and response to chemoradiation, and an increased rate of recurrence. This finding is possibly due to the relationship between immunosuppression and hypoalbuminemia, which was associated with worse overall and progression-free survival. Copyright © 2019 Elsevier Inc. All rights reserved.

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