Squamous cell carcinoma of the anal canal at the Queen Elizabeth Hospital: A local experience

Abstract

Aim: Concurrent chemoradiotherapy is the standard treatment for squamous cell carcinoma of anal canal. We describe our experience of treating such patients at our center. Methods: Patients with anal squamous cell carcinoma were treated with a uniform sphincter preserving protocol at The Queen Elizabeth Hospital, South Australia. Standard radiotherapy along with 5-fluorouracil (750 mg/m² on days 1–5 and days 29–32) and mitomycin C (12 mg/m² on day 1 only) was given to eligible patients. Results: Of the 34 patients included in this study, nearly 60% were women. Most (89.3%) had T1-2 disease. One-third had nodal involvement. Twenty-seven had chemoradiotherapy, six had local excision alone and one had radiotherapy alone. Among those who had chemoradiation, 71.5% had a complete response and remained colostomy free until the last follow-up. Most completed the treatment without major side-effects. The 3 and 5-year disease free survival rate was 62% and 53%, respectively. All patients who failed chemoradiation underwent salvage surgery with a median survival time of 32.5 months. Conclusion: Sphincter preservation is the goal for anal cancers. Chemoradiotherapy is an important modality to achieve this goal.