Patterns of recurrence in squamous cell carcinoma of the anal canal

The objective of the study was to identify the patterns of recurrence in patients with squamous cell carcinoma of the anal canal (SCCAC) vs. the size of the primary tumor and its further possible impact on its treatment outcome. We reviewed 78 patients treated between 1975 to 1991. They were classified according to to the AJC/UICC classification. From 1975 to 1985, 16 patients were treated with radical surgery (RS). From 1985 to 1991, 43 patients were treated with radiotherapy (RT) at doses of 45 Gy/4-5 weeks, to the pelvis and a boost of 15-30 Gy to the perineum. Since 1989, in 19 selected patients, 5-FU and mitomycin-C have been added to the RT schedule (C-RT). There were 55 females and 23 males. The overall recurrence rate was 62%. In T1 tumors, no recurrences occurred. The local recurrence (LR) according to treatment approach and T were: radical surgery: T2, 50%; T3, 71%; T4, 100%. Radiation therapy: T2, 25%; T3, 41%; T4, 66%. Chemoradiation therapy: T2, 12%; T3, 40%; T4, 50%. Regional recurrences were in RS: T2, 16%; T3, 28%; T4, 100%. RT: T2, 0%; T3, 16%; T4, 33%. C-RT: T2, 0%; T3, 20%; T4, 25%. Distant recurrences were in RS: T2 and T3, 0%; T4, 66%. In RT: T2, 0%; T3, 8%; T4, 33%. In C-RT: T2, 0%; T3, 8%; T4, 50%. In T1 patients, no recurrences were observed. In T2 tumors the recurrence pattern was local. In T3 tumors it was locoregional and to the groin area. In T4 tumors it was locoregional and distant.(ABSTRACT TRUNCATED AT 250 WORDS)