Lower GI 2016

Anal Cancer : the importance of nodal metastasis

• Das et al ( 2007 ) : 167 patients treated with CRT

3 yr locoregional control 3 yr distant control

N0 85 % 94 % N1 88 % 79 % N2 84 % 75 % N3 39 % 76 %

N stage an independent predictor of loco-regional failure, distant metastasis and OS on multivariate analysis !

Ajani et al ( 2010 ) : RTOG 98-11 trial Clinically positive nodes associated with worse 5 yr DFS and 5 yr OS ( p < 0.0001 )