{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T08:49:23Z","timestamp":1778143763602,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Chemoradiation therapy (CRT) is considered as the first line of treatment for patients with squamous cell carcinoma of the anal canal. Following initial CRT, patients who present with either persistent or locally recurrent disease are treated by surgical intervention. The aim of our study is to determine the prognostic factors associated with failure of CRT and overall mortality in patients with anal squamous cell carcinoma (SCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a 14\u2010year analysis (2004\u20132017) of the National Cancer Database and included patients diagnosed with non\u2010metastatic SCC of the anal canal who underwent CRT. Baseline patient characteristics including demographics, comorbidities and tumour characteristics were analysed. Outcome measures were needed for operative intervention after 4\u2009months of initiation of CRT (failure of CRT) and 5\u2010year overall mortality. Multivariate logistic regression analysis identified prognostic factors independently associated with failure of CRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included a total of 37\u2009615 patients with anal SCC who received CRT. Predictors of operative intervention included male sex, higher Deyo\u2013Charlson Comorbidity Index (DCCI) and higher primary tumour stage. The 5\u2010year overall survival rate was 77.6%, and 2.4% of patients failed CRT, defined as requiring and undergoing surgical intervention within 4\u2009months post\u2010initiation of CRT. Median follow\u2010up time was 47 (95% CI 24\u201384) months. Independent predictors of overall mortality within the first 5\u2009years of diagnosis were increased age, male sex, Black race, non\u2010insured status, higher DCCI, higher primary tumour grade, and higher primary tumour and lymph node stage. The 5\u2010year survival rate was significantly lower in patients who underwent operative intervention compared to those who received CRT alone (57.4% vs. 78.1%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study showed that male sex, younger age, DCCI of 1 and 3, and increased tumour size were predictive of CRT failure among patients with anal SCC. Increased age, male sex, Black race, non\u2010insured status, increased DCCI, and more aggressive tumour characteristics were associated with increased 5\u2010year overall mortality. More importantly, patients who failed CRT had worse 5\u2010year overall survival. Our findings support increased emphasis on intensive surveillance for these high\u2010risk patient cohorts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.17225","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T23:54:02Z","timestamp":1732751642000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic factors associated with worse outcomes following chemoradiation therapy in patients with anal carcinoma"],"prefix":"10.1111","volume":"27","author":[{"given":"Muhammad","family":"Khurrum","sequence":"first","affiliation":[{"name":"Department of Surgery NYU Langone Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Arizona College of Medicine\u2010Tucson  Tucson Arizona 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