246P - Clinical profile and outcomes of carcinoma anal canal: A single institution experience (246P)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Anal Cancer
Gastrointestinal Cancers
Presenter DEEPAK Koppaka
Citation Annals of Oncology (2017) 28 (suppl_10): x57-x76. 10.1093/annonc/mdx660
Authors D. Koppaka, K.C. Lakshmaiah, K.G. Babu, L. Dasappa, L.A. Jacob, M.C.S. Babu, K.N. Lokesh, A.H. Rudresha, L.K. Rajeev, S.C. Saldanha
  • Medical Oncology, KIDWAI Memorial Institute of oncology, 560029 - Bangalore/IN

Abstract

Background

Carcinoma anal canal is a rare disease. Due to the sparse data from India pertaining to the treatment modalities and outcomes of this disease, we have attempted to study the clinical profile and outcomes of radically treated patients with carcinoma anal canal.

Methods

Data of all patients diagnosed with carcinoma anal canal from January 2013 to December 2016 were analyzed. Clinical symptoms, stage, treatment modality received, colostomy-free survival(CFS), the impact of radiation dose & the number of chemotherapy cycles on CFS and overall survival were analyzed.

Results

Thirty-three patients with squamous cell carcinoma of anal canal treated radically were considered. The median age was 55 years (Range, 27- 82 years), with a male to female ratio of 1.2:1. Common symptoms were pain during defecation (90%), bleeding (79%), constipation (72%), anal discharge (29%), and groin swellings (22%). Two patients had HIV/AIDS. At presentation 4 patients were stage II, 18 were stage IIIA and 11 were stage IIIB. The treatment modalities used were chemoradiation (76%), surgery (15%) and radiotherapy (9%). After a median follow-up of 22 months, the overall survival was 73%. A significant progression-free survival difference was noted between patients receiving chemoradiation versus the other modalities (p = 0.005). Five patients underwent upfront abdominopelvic resection of which 2 had a loco-regional recurrence and one had liver metastasis. Of the patients treated with chemoradiation or radiotherapy alone, 79% (n = 22) patients were alive and of this 73% (n = 16) were colostomy-free. Persistent residual disease at 6 months or progressive disease were present in 40% (n = 11) patients and salvage abdominopelvic resection surgery was performed in 55% (n = 6) of these patients. Neither the dose of radiotherapy (45-50.4Gy versus 54-60Gy) (p = 0.549) nor the number of chemotherapy cycles (1 versus 2 cycles) (p = 0.901) had an impact on CFS.

Conclusions

Chemoradiation remains the standard of care in the management of squamous cell carcinoma of the anal canal. The dose of radiation (45-50.4Gy versus 54-60Gy) and the number of chemotherapy cycles did not have a significant impact on colostomy-free survival in our study, a large randomized study addressing this issue is needed.

Clinical trial identification

Legal entity responsible for the study

Kidwai Institute of Medical Oncology

Funding

Kidwai Memorial Institute of Oncology

Disclosure

All authors have declared no conflicts of interest.