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@ARTICLE{Fuchs:298617,
      author       = {F. Fuchs and P. Rogowski and M. Rottler and M. A. Shouman
                      and K. Heinrich$^*$ and F. Kühn$^*$ and C. Belka$^*$ and K.
                      Unger$^*$ and F. Walter$^*$},
      title        = {{R}adio(chemo)therapy in anal cancer: evaluation of
                      sex-specific disparities across {AJCC} stages.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {nn},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2025-00317},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {This study aimed to investigate sex differences in anal
                      squamous cell carcinomas (ASCC), with a particular focus on
                      the prognostic significance of the American Joint Committee
                      on Cancer (AJCC) 9th edition staging system for oncological
                      outcome.A retrospective analysis was conducted in 188
                      patients with histologically confirmed ASCC who underwent
                      definitive (chemo)radiotherapy between 2004 and 2020.
                      Patient- and tumor-related data were collected. Tumor stage
                      groups were classified according to the AJCC 9th edition.
                      Overall survival (OS), disease-free survival (DFS), freedom
                      from recurrence (FFR), and colostomy-free survival (CFS)
                      were analyzed using the Kaplan-Meier method for univariate
                      testing and Cox regression models for multivariate analysis.
                      Differences between sexes were assessed.The cohort included
                      134 females and 54 males, with a median follow-up of 83
                      months. Females exhibited significantly better OS (p =
                      0.01), DFS (p = 0.01), and CFS (p = 0.03). For male
                      patients, there was a clear trend towards better OS (p =
                      0.08), DFS (p = 0.10), and FFR (p = 0.09) in earlier tumors
                      as well as significantly better CFS (p = 0.04). In contrast,
                      in the female subgroup, there were no significant
                      differences in OS (p = 0.64), DFS (p = 0.52), and CFS (p =
                      0.25) with respect to tumor stage. In multivariate analysis,
                      male sex, older age, and advanced tumor stages were
                      significant risk factors for poorer OS, DFS, and CFS.This
                      study highlights significant sex differences in ASCC
                      prognoses, with females showing better survival outcomes.
                      The prognostic value of the AJCC 9th edition staging system
                      differs between sexes; thus, we support the inclusion of sex
                      as a prognostic factor in staging systems.},
      keywords     = {AJCC staging system (Other) / Anal carcinoma (Other) /
                      Chemoradiotherapy (Other) / Gender medicine (Other) / Sex
                      disparities (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39918562},
      doi          = {10.1007/s00066-025-02368-1},
      url          = {https://inrepo02.dkfz.de/record/298617},
}