title: Treatment that follows guidelines closely dramatically improves overall survival of patients with anal canal and margin cancers.
abstract: BACKGROUND
  To assess relevance of ESMO-ESSO-ESTRO treatment guidelines in a retrospective analysis of patients with anal canal or anal margin cancers.
  
  
  METHODS
  155 patients were separated into standard treatment group (STG), treated according to or closely the guidelines, and an altered treatment group (ATG).
  
  
  RESULTS
  The median follow-up time was 50.7 months. In the STG, the 5- and 10-year LR-DFS rates were 75.2% and 72.7%; in the ATG, they were 66.8% and 61.2%, respectively. In the STG, the 5- and 10-year OS rates were 81.8% and 68%; in the ATG, they were 63.3% and 49.5%, respectively (p=0.037). In the multivariate analysis, favorable prognostic factors for OS included the standard treatment, age <60, tumor <T3, no HIV infection and a total radiation dose >50.4Gy.
  
  
  CONCLUSIONS
  This study identifies the superiority of treatment according to standard guidelines compared to altered treatment. Our results corroborate the guidelines.
authors.affiliation: General and Digestive Surgery Department, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 2 Avenue Molière 67200 Strasbourg, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Delhorme
authors.affiliation: Radiotherapy Department, Centre Paul Strauss, 3, Rue de la Porte de l'Hôpital, 67065 Strasbourg Cedex, France; Radiobiology Lab., EA3430, Strasbourg University, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Antoni
authors.affiliation: Harvard Radiation Oncology Program, Boston, MA, United States; Department of Radiation Oncology, Boston Medical Center, Boston, MA, United States.
authors.forename: Kimberley S
authors.initials: KS
authors.lastname: Mak
authors.affiliation: Public Health Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France.
authors.forename: François
authors.initials: F
authors.lastname: Severac
authors.affiliation: Genetic, Genomic, Microbiology Department, Strasbourg University/CNRS, UMR 7156, Strasbourg, France.
authors.forename: Kelle C
authors.initials: KC
authors.lastname: Freel
authors.affiliation: Radiotherapy Department, Centre Paul Strauss, 3, Rue de la Porte de l'Hôpital, 67065 Strasbourg Cedex, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Schumacher
authors.affiliation: General and Digestive Surgery Department, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 2 Avenue Molière 67200 Strasbourg, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Rohr
authors.affiliation: General and Digestive Surgery Department, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 2 Avenue Molière 67200 Strasbourg, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Brigand
authors.affiliation: Radiotherapy Department, Centre Paul Strauss, 3, Rue de la Porte de l'Hôpital, 67065 Strasbourg Cedex, France; Radiobiology Lab., EA3430, Strasbourg University, France. Electronic address: gnoel@strasbourg.unicancer.fr.
authors.forename: Georges
authors.initials: G
authors.lastname: Noel
mesh_terms: D001005:Anus Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
keywords: Adherence to treatment guidelines; Altered treatment; Anal cancer; Chemotherapy; Radiotherapy