SQUAMOUS-CELL CARCINOMA OF THE ANAL REGION AT THE KING-FAISAL-SPECIALIST-HOSPITAL AND RESEARCH-CENTER

This study documents the epidemiological aspects of squamous cell carcinoma of the anus and anal canal as it has presented to the King Faisal Specialist Hospital and Research Centre (KFSH&RC). Thirty-eight (33 Saudis) patients, 24 males and 14 females were studied. They ranged in age from 32 to 100 years. Twenty-four had anal canal tumors and 12 had anal margin cancers. Riyadh, the Eastern Province or Medina provided most patients and the majority presented with bleeding, a lump or pain. Symptom duration ranged from one month to more than two years. Fourteen had previous anal problems. There was an almost equal distribution of lesions between the anterior and posterior halves ot the anus. Nineteen had clinically normal inguinal nodes. Thirty had squamous cell carcinoma (epidermoid) and eight had cloacogenic/basiloid tumors. Most tumors were either moderately or poorly differentiated. Twenty-eight presented with T3 or T4 tumors and only ten presented with T1 or T2 tumors. Five had evidence of metastases at initial presentation. Eight were treated by abdominoperinal resection of the rectum. A diversion colostomy was performed in six. Fifteen received radiotherapy alone but only three were treated by chemotherapy alone. Combination chemotherapy and radiotherapy was given to 14. More males than females had both anal canal and anal margin tumors. Patients with anal margin tumors were on average ten years older. There were twice as many with anal canal as anal margin tumors. There were more node-positive patients with anal margin tumors. Anal canal tumors were less well-differentiated. Follow-up was inadequate.