Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jul 24, 2023; 14(7): 259-264
Published online Jul 24, 2023. doi: 10.5306/wjco.v14.i7.259
Relationship between anal cancer recurrence and cigarette smoking
Kevin R McMahon, Nicholas Gemma, McKenzie Clapp, Patricia Sanchez-Montejo, Joseph Dibello, Erica Laipply
Kevin R McMahon, Nicholas Gemma, McKenzie Clapp, Patricia Sanchez-Montejo, Joseph Dibello, Erica Laipply, Department of General Surgery, Summa Health System, Akron, OH 44304, United States
Author contributions: McMahon KR designed and performed the research and wrote the paper; Gemma N helped write and revise the report; Dibello J assisted with data curation and editing of the report; Clapp M assisted with data curation and editing the report; Sanchez-Montejo P assisted with data analysis and editing the report; Laipply E designed the research and supervised the report.
Institutional review board statement: The study was reviewed and approved by the Summa Health System Institutional Review Board (Approval No. 21176).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to inclusion in the cancer registry used in this review.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: Statistical code and dataset available from the corresponding author at kevin.mcmahon88@outlook.com. Consent was not obtained, but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kevin R McMahon, MD, Doctor, Department of General Surgery, Summa Health System, 55 Arch Street, Akron, OH 44304, United States. mcmahonkr@summahealth.org
Received: February 23, 2023
Peer-review started: February 23, 2023
First decision: March 28, 2023
Revised: May 10, 2023
Accepted: June 13, 2023
Article in press: June 13, 2023
Published online: July 24, 2023
Processing time: 145 Days and 14.1 Hours
Abstract
BACKGROUND

The incidence of anal cancer has been increasing in the United States. Smoking is a well-established risk factor; however, the impact of smoking on disease re-currence and outcome has not been well studied. The aim of this study was to assess the association between anal cancer recurrence and cigarette smoking.

AIM

To investigate the relationship between cigarette smoking status and anal cancer treatment outcome.

METHODS

The cancer registry from a single, community hospital was screened for patients with anal cancer between 2010 and 2021. The following characteristics were gathered from the database: Age; sex; cigarette smoking history; American Joint Committee on Cancer Clinical Stage Group; response to therapy; recurrence; time to recurrence; mortality; time to death; and length of follow-up. Patients were divided into the following groups: Current smokers; former smokers; and never smokers. SPSSv25.0 software (IBM Corp., Armonk, NY, United States) was used for statistical analysis.

RESULTS

A total of 95 patients from the database met the screening criteria. There were 37 never smokers, 22 former smokers, and 36 current smokers. There was no difference between groups in regards to race or sex. There was no difference in the American Joint Committee on Cancer Clinical Stage Group between groups. The former smokers were significantly older when compared to never smokers and current smokers (66.5 ± 13.17 vs 57.4 ± 7.82 vs 63.7 ± 13.80, P = 0.011). Former smokers and current smokers had a higher recurrence rate compared to never smokers (30.8% and 20.8% compared to zero, P = 0.009). There was not a significant difference in recurrence between former smokers and current smokers. There was no difference in the mortality, non-response rate, or time to death between the groups.

CONCLUSION

Our data contributes evidence that cigarette smoking status is associated with increased recurrence for patients with anal cancer.

Keywords: Anal cancer; Smoking; Recurrence; Nigro protocol; Chemoradiation; Retrospective review

Core Tip: This retrospective review examined the impact of smoking on anal cancer treatment for 95 patients. Smoking status was associated with a significantly higher rate of anal cancer recurrence after standard treatment. There was not a significant association between smoking status and anal cancer treatment non-response or mortality. Further study is needed to determine if smoking cessation would alter the course of anal cancer or if adjunct therapy would be beneficial in patients with anal cancer and a smoking history.