Squamous cell carcinoma of the anal canal: Radical and palliative treatments and prognosis

From January 1978 to December 1992, 20 patients with squamous cell carcinoma of the anal canal were treated here; 12 patients received radical treatment using a multimodality approach and eight patients, palliative treatment. Follow-up times of the patients ranged from 30 to 142 months, with a mean follow-up time of 87 months for radical treatment, 8 (67%) of 12 patients had wide local excision initially. One patient retained anal continence and 11 patients required abdominoperineal resection. The overall five-year survival rate after wide local excision or abdominoperineal resection was 75%. There were no treatment-related deaths. Preoperative tumor size, was the factor most significantly related to survival. Patients should be treated with chemoradiotherapy; if the treatment fails or the tumor recurs, surgical therapy is used to control local disease. Of those with palliative treatment, all 8 patients died of bilateral hepatic metastases between 3 to 35 months.