Management of carcinoma of anal canal.
The application of various treatment modalities in the management of carcinoma of the anal canal remains controversial. Forty-nine patients were reviewed from the affiliated hospitals of the Medical College of Wisconsin. Exclusions for postoperative deaths, associated vulvar carcinoma, and lack of follow-up left 35 patients for determinate study. The overall 5-year survival rate was 28.6% (10 of 35). When reviewed by stage of disease, a direct relationship between advanced stage and decreased survival (i.e., 60% five-year survival rate with stage I, 25% with stage II, and 14.3% with stage III) was noted. Further reclassification of stage III, nodal involvement, showed the same survival for perirectal nodal involvement as for synchronous inguinal node involvement. Seven of ten 5-year survivors received a combined surgery-radiotherapy approach. In addition, in those patients receiving tumoricidal radiation pre- or postoperatively, no local recurrence was demonstrated. A treatment protocol of abdominal perineal resection, with combined radiation therapy for locally advanced lesions, is proposed.
D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000401:mortality / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D011879:Radiotherapy Dosage