Salvage Surgery for Anal Canal Ca. Long Term Outcomes From a Tertiary Referral Centre

Abstract

Purpose: The purpose of this study was to analyse the outcome of salvage surgery in the management of anal canal cancer.Methodology: All patients with a diagnosis of anal canal carcinoma from 2006 to 2015 were studied. Basic demographic data were recorded. Treatment modalities used were recorded for all patients. Long-term surgical outcomes were recorded. Median survival in months was recorded. All data were recorded in the SPSS ver. 20.Results: A total of 62 patients were included in the study. Median age was 51. 38 patients had SCCa on histology and 24 had an adenocarcinoma. 52% of patients had a T4 lesion. Chemoradiotherapy (CRT) was offered to 59 (95%) patients as the first line of therapy. 12 (19%) patients had a complete response. 37 (60%) patients had a partial and 10 (16%) patients had no response to chemoradiation. Salvage surgery was offered to 27 patients. Of these, 21 had a curative resection. Six had irresectable disease and underwent a colostomy only. Median overall survival for all patients was 46 months with a 5-year survival of 55%. Patients with partial response who were offered salvage surgery the 5-year survival were 40%. For patients with no response or progressive disease after chemoradiation therapy, the 5-year survival was 20%.Conclusion: Long-term survival can be achieved in majority of patients who undergo radical salvage surgery after failed CRT for carcinoma of the anal canal.Key words: Adenocarcinoma, anal canal, chemoradiotherapy, surgery