Analysis of outcomes achieved with squamous cell carcinomas of the anus in a single university hospital over the last two decades: Clinical response rate, relapse and survival of 190 patients

J Surg Oncol. 2018 Feb;117(2):269-274. doi: 10.1002/jso.24794. Epub 2017 Sep 10.

Abstract

Background and objectives: We reviewed our series of anal squamous cell carcinomas (ASCC) treated over the last two decades.

Methods: ASCC patients undergoing treatment at the Leicester Royal Infirmary between 1998 and 2016 were selected. Age, gender, pathological tumor characteristics, treatment adopted, the overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) at 5-year follow-up were recorded and calculated.

Results: A total of 190 ASCC were reviewed, of these 64.2% (n = 122) received primary radical chemoradiotherapy. Complete response rate was 92.6% (n = 113) and four patients with residual disease underwent a salvage APER. Twenty-eight patients experienced recurrent disease (23.0%) either systemic (n = 8), local (n = 14), or both (n = 6); six had a salvage APER. Complete follow-up data are available for 63.1% patients (77/122). Overall, the locoregional failure rate of primary chemoradiotherapy (residual + recurrent disease) was present in 29 patients (29/122; 23.8%). OS was 41.6% CSS was 69.2% and DFS 60.0% at 5 years follow-up.

Conclusions: In our series of ASCC primary chemoradiotherapy had achieved significant initial complete response rates, however, long term-follow ups still present systemic and local recurrences. APR is able to treat 30% of the pelvic recurrences (6/20), the others are either associated with systemic disease or locally inoperable masses.

Keywords: anal squamous cell carcinoma; chemoradiotherapy; recurrences; survival.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Anus Neoplasms / mortality*
  • Anus Neoplasms / pathology
  • Anus Neoplasms / therapy
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy / mortality*
  • Combined Modality Therapy / mortality*
  • Female
  • Follow-Up Studies
  • Hospitals, University / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Survival Rate