{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T06:59:32Z","timestamp":1764831572095,"version":"3.46.0"},"reference-count":29,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007397","name":"Charles University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Anal squamous cell carcinoma (ASCC) is a rare malignancy primarily treated with chemoradiotherapy (CRT). This study evaluated outcomes and the prognostic value of simple hematologic indices in patients receiving modern image-guided CRT. Methods: Fifty-five patients with non-metastatic ASCC treated between 2017 and 2025 were retrospectively analyzed. Survival was estimated by Kaplan\u2013Meier methods, and prognostic factors were assessed by log-rank testing and Cox regression. Baseline neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios were analyzed individually and in combination with nodal status. Results: At a median follow-up of 53.1 months, overall survival reached 90% at 5 years, whereas disease-free survival declined to 51%. Nodal positivity showed a non-significant trend toward poorer DFS. Baseline PLR \u2265 150 was significantly associated with inferior DFS in univariable analysis (HR 5.28, 95% CI 1.12\u201324.97, p = 0.036), while NLR \u2265 3 showed a borderline effect (p = 0.108). In multivariable models, PLR retained borderline prognostic relevance (p = 0.083), whereas Kaplan\u2013Meier curves indicated non-significant trends (p = 0.129 and 0.055). Integrated models combining nodal status with PLR \u00b1 NLR improved risk discrimination: Model A (N + PLR \u2265 150 \u00b1 NLR \u2265 3) showed a trend (p = 0.059), and Model B (N + PLR \u2265 150) reached significance (p = 0.021; C-index \u2248 0.68\u20130.69). Conclusions: Modern CRT achieved excellent OS with acceptable toxicity, though early recurrences limited DFS. Integrating hematologic indices with nodal status provides a pragmatic, cost-effective approach for individualized risk assessment and follow-up in ASCC.<\/jats:p>","DOI":"10.3390\/cancers17233838","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T10:34:01Z","timestamp":1764758041000},"page":"3838","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Hematologic Indices and Composite Models in Anal Squamous Cell Carcinoma Treated with Image-Guided Chemoradiotherapy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7396-018X","authenticated-orcid":false,"given":"So\u0148a","family":"Argal\u00e1csov\u00e1","sequence":"first","affiliation":[{"name":"Department of Oncology, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2124-6766","authenticated-orcid":false,"given":"Petr","family":"Dytrych","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-7296","authenticated-orcid":false,"given":"Monika","family":"W\u00e1gnerov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Radiology, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-224X","authenticated-orcid":false,"given":"Vladim\u00edr","family":"\u010cern\u00fd","sequence":"additional","affiliation":[{"name":"Department of Radiology, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9703-209X","authenticated-orcid":false,"given":"Jan","family":"\u0160pa\u010dek","sequence":"additional","affiliation":[{"name":"Department of Oncology, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5187-809X","authenticated-orcid":false,"given":"Stanislav","family":"Hlou\u0161ek","sequence":"additional","affiliation":[{"name":"Department of Oncology, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1903-5361","authenticated-orcid":false,"given":"Pavel","family":"Ko\u017eelsk\u00fd","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7005-3795","authenticated-orcid":false,"given":"Jakub","family":"Tesa\u0159","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2948-8989","authenticated-orcid":false,"given":"David","family":"Hoskovec","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9386-657X","authenticated-orcid":false,"given":"Michal","family":"Vo\u010dka","sequence":"additional","affiliation":[{"name":"Department of Oncology, General University Hospital in Prague and First Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"ref_1","unstructured":"Global Cancer Observatory (GCO), and International Agency for Research on Cancer (IARC) (2025, September 25). 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