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Comment & Response
July 2018

Limitations of the National Cancer Data Base to Evaluate Early-Stage Anal Cancer Treatment Outcomes

Author Affiliations
  • 1Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
  • 2Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom
  • 3Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
  • 4Leeds Institute of Cancer and Pathology, University of Leeds, St James’s University Hospital, Leeds, United Kingdom
JAMA Surg. 2018;153(7):691. doi:10.1001/jamasurg.2018.0394

To the Editor Using the National Cancer Data Base, Chai et al1 analyzed arguably the largest cohort of early-stage (T1N0) squamous cell carcinoma of the anal canal in the literature and concluded that local excision may be a treatment option in these patients. We strongly urge caution regarding this interpretation and remind the readership that the European Society for Medical Oncology–European Society of Surgical Oncology–European Society for Radiotherapy and Oncology guidelines2 consider this approach to be contraindicated.

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