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Anal squamous cell carcinoma: are we improving outcomes?
Author(s) -
Mackowski Alicia,
Levitt Michael,
Makin Gregory,
Salama Paul,
Tan Patrick,
Penter Cheryl,
Platell Cameron
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14745
Subject(s) - medicine , anal cancer , abdominoperineal resection , surgery , malignancy , regimen , anal canal , confidence interval , stage (stratigraphy) , wide local excision , salvage therapy , cancer , chemotherapy , colorectal cancer , rectum , paleontology , biology
Background Anal squamous cell carcinoma (SCC) is a rare malignancy. The purpose of this study was to review a single institution's experience. Methods All patients with anal SCC from St John of God Subiaco Hospital database were identified over a 10‐year period (2006–2016). Patients with stage 1 anal verge tumours underwent wide local excision, all remaining patients were offered chemoradiation (CRT) as an initial treatment modality (a fluorouracil‐based regimen in conjunction with mitomycin). Outcomes included recurrence, overall survival and survival following salvage surgery. Results Forty‐seven patients were identified. Median age was 60 years and median follow‐up was 2.73 years. Five‐year rates of recurrence and overall survival were 35.8% (95% confidence interval (CI) 23.2–52.4%) and 65.4% (95% CI 47.0–78.7%), respectively. Locoregional failure occurred most commonly at the primary site. Eight patients underwent salvage abdominoperineal resection for persistent or recurrent disease, and four of these patients died within 5 years. Conclusion CRT is a proven and reasonable effective approach in managing anal cancer. Observed recurrence and overall survival rates in this study resemble the published data. Despite newer methods of treatment being investigated, the treatment for anal SCC has not significantly changed in the past four decades and novel approaches are needed to further improve outcomes.