title: Anal canal carcinoma treatment results: the experience of a single institution.
abstract: OBJECTIVE
  Prior to the mid-1980s, the treatment of choice for anal cancer was abdominoperineal resection. Currently, combined chemoradiation is the standard of care. Or objective was to analyze results of treatment for anal canal carcinoma treated with combined chemoradiation.
  
  
  METHODS
  Retrospective review of data in local cancer registry at King Faisal Specialist Hospital and Research Centre (KFSHRC) from a 12-year period (1993 to 2005).
  
  
  METHODS
  We identified patients with confirmed diagnosis of anal canal squamous cell carcinoma.
  
  
  RESULTS
  Of 40 patients identified, 33 were considered eligible for our analysis. All patients were treated by concurrent chemoradiation with mandatory treatment break (MTB) There were 10 (30%) local recurrences. Five-year progression-free survival (PFS) was 50.9%; overall survival (OS) at 5 years was 73.4%. Patients with stage II disease had a median PFS period of 10 years, with no relapses until their last follow-up. There was no statistically significant difference in PFS between patients with stage IIIA disease and those with stage IIIB disease-44.7% and 45%, respectively (P=.8). Five-year PFS according to 'T' stages was as follows: T1, 66%; T2, 71%; T3, 59%; T4, 30% (P>.05). The 5-year colostomy-free survival (CFS) for all patients was 74%. Distant metastases were observed in 4 patients.
  
  
  CONCLUSIONS
  Combined chemoradiation in treatment of anal cancer is effective in terms of local control and sphincter preservation. Five-year estimates of PFS, OS, as well as CFS, in patients treated with a MTB were surprisingly comparable to those determined in most non-MTB series. However, we reported a higher local failure rate, for which we are reevaluating our treatment protocol.
authors.affiliation: Department of Radiation Oncology, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Mostafa
authors.initials: M
authors.lastname: El-Haddad
authors.forename: Raef S
authors.initials: RS
authors.lastname: Ahmed
authors.forename: Abdallah
authors.initials: A
authors.lastname: Al-Suhaibany
authors.forename: Manal
authors.initials: M
authors.lastname: Al-Hazza
authors.forename: Nasser
authors.initials: N
authors.lastname: Al-Sanae
authors.forename: Alaa Abd
authors.initials: AA
authors.lastname: Al-Jabbar
authors.forename: Samar
authors.initials: S
authors.lastname: Hamoud
authors.forename: Loay
authors.initials: L
authors.lastname: Ashaary
authors.forename: Shouky
authors.initials: S
authors.lastname: Bazerbashy
authors.forename: Khaled
authors.initials: K
authors.lastname: Balaraj
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000503:physiopathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D012529:Saudi Arabia; D013534:Survival; D016896:Treatment Outcome