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Locally advanced anal cancer: A single center analysis
Anal cancer is an uncommon diagnosis; however, its incidence has been increasing, particularly in women, as well as global awareness of this disease. Most anal cancers are squamous cell carcinomas, which are strongly linked to human papillomavirus infection. Combined chemoradiotherapy remains the standard of care for patients with non-metastatic disease, with surgery being reserved for salvage therapy.
We aimed to retrospectively review the patients diagnosed with locoregional squamous cell anal cancer at our institution between 2015 and 2020. We excluded metastatic disease. Demographic and clinical characteristics were retrospectively assessed, as were oncological outcomes. Kaplan-Meier analysis was used to assess disease-free survival (DFS) and overall survival (OS).
A total of twenty-eight patients were identified, of which 18 were females (64.3%) and 10 were males (35.7%). The median age at diagnosis was 54 years old (41-68). The majority of patients presented with a clinical stage of IIIC (42.9%) and had clinically positive lymph nodes. All patients were treated with chemoradiotherapy, with 3 patients requiring salvage surgery. Most patients received a total dose between 50 to 60Gy to the tumor volume, and the majority were treated with mitomycin combined with 5-fluorouracil (46.4%). Persistent disease was observed in four patients, with 3 being submitted to abdominopelvic amputation and one patient dying for reasons unrelated to the oncological diagnosis. Relapse was observed in 12 patients (42.9%), with the majority (10 patients) recurring locally. Median DFS was 28.3 months (8-82 months) and median OS was 59.8 months (14-84 months). There were four deaths, all related to disease relapse and progression.
Our study validated the relevance of the chemoradiotherapy protocol. However, new and more data are needed to optimize the post-relapse strategy.
The authors.
Has not received any funding.
All authors have declared no conflicts of interest.
