Premium
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
Author(s) -
Gravante Gianpiero,
Stephenson James Andrew,
Elshaer Mohamed,
Osman Ahmed,
Vasanthan Subramaniam,
Mullineux Joseph H.,
Gani Mohamed Akil Dilawar,
Sharpe David,
Yeung Justin,
Norwood Michael,
Miller Andrew,
Boyle Kirsten,
Hemingway David
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24794
Subject(s) - medicine , chemoradiotherapy , anus , surgery , squamous cell cancer , survival rate , anal cancer , systemic therapy , oncology , cancer , gastroenterology , chemotherapy , breast cancer
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.