Treatment of carcinoma of the anal canal at Groote Schuur Hospital

S Afr Med J. 2012 May 23;102(6):559-61. doi: 10.7196/samj.5674.

Abstract

Objectives: Chemoradiation is the treatment of choice for squamous carcinoma of the anal canal, resulting in the same local control rates as surgery but with the advantage of organ function preservation. We aimed to review all cases of anal canal carcinoma treated at Groote Schuur Hospital between 2000 and 2004 and to assess treatement outcome.

Methods: The records for 31 patients presenting during this period were reviewed. Patient and tumour characteristics were recorded. Twenty-six patients were treated with chemoradiation. Local failure-free, colostomy-free and overall survival were calculated using the Kaplan-Meier method.

Results: Compared with the literature, the median patient age was younger and the stage was more advanced in this study. The complete response rate for all stages with chemoradiation was 80%. The local failure-free survival at 5 years was 60.7%. Colostomy-free and overall survival at 5 years were 59.2% and 65.6%, respectively.

Conclusions: The patients presented with locally advanced disease. Chemoradiation is effective treatment for this group of patients and the majority avoid a permanent colostomy as they preserve anal sphincter function.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Anus Neoplasms / pathology*
  • Anus Neoplasms / therapy*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy* / adverse effects
  • Colostomy
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Female
  • Fluorouracil / administration & dosage
  • Hospitals, University
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Neoplasm Staging
  • Radiodermatitis / etiology
  • Retrospective Studies
  • South Africa
  • Treatment Outcome
  • Young Adult

Substances

  • Mitomycin
  • Fluorouracil