Anal canal cancer is a relatively rare malignancy, constituting approximately 1-2% of all digestive tract tumors and 2-4% of colorectal and anal tumors. This disease encompasses various histological subtypes, such as squamous cell carcinomas (SCC), adenocarcinoma, adeno-squamous carcinoma, and melanoma. The primary objective of this study is to explore survival rates and discern the key factors that impact survival in patients diagnosed with anal canal cancer.

A retrospective study was undertaken, analyzing the medical records of 70 patients who had been diagnosed with anal canal cancer. We gathered data by conducting a thorough review of medical records and conducting telephone interviews. To estimate survival rates, we employed the life table method, and to make subgroup comparisons, we employed the log-rank test. Additionally, we utilized Cox regression analysis to evaluate the independent relationships between survival time in anal canal cancer and various covariates.

During the study period, we identified a total of 70 patients, with 41 of them being male, who were diagnosed with either adenocarcinoma or SCC (1.4%). The mean age at the time of initial diagnosis was 57.49 years, with a range spanning 69 years. The most frequently reported symptoms among these patients included bleeding (n = 63, 90%), altered bowel habits (n = 4, 5.7%), and pain (n = 3, 4.3%). Patients were categorized into American Joint Committee on Cancer (AJCC) stages as follows: localized (25, 35.6%), regional (25, 35.6%), metastasis (12, 17.4%), and some with unknown stage. Thirty-seven patients (52.90%) underwent abdominoperineal resection, while 22 patients were deemed inoperable. The estimated survival rates at the 1st, 3rd, and 5th years were 83%, 52%, and 44%, respectively (refer to Fig. 1). Univariable analysis revealed that several factors, including age, symptoms, stage, neoadjuvant chemoradiotherapy, surgery (Fig. 2), and colostomy, were predictive of overall survival (OS). In our multivariate Cox proportional-hazards analysis, we observed that individuals with regional stage disease (HR=5.23, 95% CI, 1.63-17.74) faced a significantly higher risk of mortality.

In our study area, anal canal cancer presents a challenging prognosis. Notably, early-stage cases exhibit more favorable overall survival outcomes, underscoring the urgency for increased focus on early detection and timely treatment interventions.