Sekhar H et al. – It is known that among patients with squamous cell carcinoma of the anus (SCCA), lymph node positivity (LNP) is associated with a poor prognosis; however, the current analysis showed that the LNP proportions of > 30% are higher than the true LNP proportion.

Methods

• A systematic review and meta-regression was conducted to quantify changes in LNP over time and the impact of this change on survival and prognostic discrimination was determined.

Results

• 62 studies reporting LNP proportions, including 10,569 patients were analyzed.
• The LNP proportions increased from a mean estimate of 15.3% in 1980 to 37.1% in 2012.
• Increasing LNP was associated with improved overall survival in lymph node-positive and -negative categories, whereas the proportions with combined tumour stage T3 and T4 remained constant.
• Across a range of LNP proportions from 15%-40%, the hazard ratios for overall survival of lymph node-positive versus -negative patients decreased significantly from 2.5 at 15% LNP to 1.3 at 40% LNP.