Outcomes in immunosuppressed anal cancer patients

Katherine Bingmer, Asya Ofshteyn, David W. Dietz, Sharon L. Stein, Emily Steinhagen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. Methods: A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. Results: 19 (14%) of 136 anal cancer patients were immunosuppressed. Immunosuppressed patients were more likely to be hypoalbuminemic (21% vs. 6%, p = 0.025), less likely to complete chemotherapy (58% vs. 80%, p = 0.031) or exhibit a complete response to chemoradiation (57% vs. 82%, p = 0.037), and more likely to experience recurrence (53% vs. 25%, p = 0.013). Hypoalbuminemia was significantly associated with worse overall (HR 6.4, CI 2.2–19.2, p < 0.001) and progression-free (HR 4.4, CI 1.8–10.4, p < 0.001) survival. Conclusions: Immunosuppressed patients have poor tolerance of chemotherapy and response to chemoradiation, and an increased rate of recurrence. This finding is possibly due to the relationship between immunosuppression and hypoalbuminemia, which was associated with worse overall and progression-free survival.

Original languageEnglish
Pages (from-to)88-92
Number of pages5
JournalAmerican Journal of Surgery
Issue number1
StatePublished - Jan 2020
Externally publishedYes


  • Anal squamous cell cancer
  • Immunosuppression
  • Organ transplant


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