Disease profile and treatment results of anal canal SCC: experience from AIIMS, New Delhi

ABSTRACT

Anal Canal squamous cell carcinoma [SSC] accounts for nearly 2% of all cancers of the alimentary tract. Over the past few years, the management of anal canal cancer has changed from primary surgery to primary chemoradiotherapy [CRT]. A total of 83 patients' [pts] records [62 males, 21 females] were retrospectively reviewed. Length of disease was <5 cm in 44 pts and confined to primary in 46 pts. Ten pts have anti-cancer therapy outside. We delivered radiotherapy [RT] alone to 16 pts, chemotherapy [CT] alone to 4 pts, CRT in 51 pts and pre-operative [pre-op] RT in 2 pts. RT dose was up to 30 Gray [Gy] =16; 30-50 Gy=12 and >50 Gy=41 pts. RT compliance was optimal in 64/69, grade [Gr] toxicity in 56/69 and Gr >/= 2 in 13/69 pts. Thirteen pts [18.84%] were hospitalized during RT. No response [NR] was found in 4/83, <50% in 18/83, >50-<`00% in 39.83 and complete response [CR] in 22/83 pts. Recurrence at primary site was seen in 7 and loco-regional in 2 pts. Salvage therapy was done in all 9 pts [surgery =8 and CT=1]. Status at last follow up, alive without disease = 22/83 and with disease = 61/83. This retrospective analysis revealed that the advanced disease was in 47%, the optimal anti-cancer therapy could be delivered to 63.9%. Despite heterogeneity of patient population and management, the overall disease-free survival [DFS] with sphincter-preservation was achieved in 26.5% pts