AB034. 51. Review of anal squamous cell carcinoma over 17 years in a tertiary referral centre

Background: Anal cancer is a rare condition, accounting for 1.5% of all lower malignancy. Globally, there has been a reported increase in incidence of anal cancer over the last few decades.

Methods: We performed a retrospective review of cases of anal squamous cell carcinoma (anal SCC) carcinoma managed at a tertiary unit over a 17-year period. We examined patient demographics, management strategies and patient outcomes. In addition, we also assessed time-related changes in incidence of Anal SCC.

Results: Sixty-seven cases of anal SCC were treated overall. Median age at presentation was 56 years (range, 32–88 years). Incidence of anal cancer increased over the 17-year study period. 97% (n=65) of patients were managed with curative intent. 60% (n=41) had > T2 disease and 25% (n=17) had node positive disease at diagnosis. Three patients had metastatic disease at presentation. 59% (n=40) had long course chemoradiotherapy (LCCRT) as initial treatment. Six patients (9%) had an abdominoperineal resection (APR) as part of their management. Five of these were salvage procedures after local recurrence. R0 resection was achieved in 66.6%. Three-year overall survival for all stages was 58.8%.

Conclusions: The incidence of anal SCC is increasing. Chemoradiotherapy remains the mainstay of initial management. A small proportion of patients will require salvage surgery. We have demonstrated salvage APR is associated with acceptable outcomes and satisfactory survival rates.

Keywords: Anal squamous cell carcinoma (anal SCC); review; abdominoperineal resection (APR); chemoradiotherapy