title: Proliferation parameters in epidermoid carcinomas of the anal canal.
abstract: OBJECTIVE
  In a prospective study, we assessed the proliferation parameters in primary epidermoid carcinomas of the anal canal, and results were compared with those in cervical carcinomas.
  
  
  METHODS
  Between January 1992 and December 1996, 32 patients with primary epidermoid carcinoma of the anal canal were studied prospectively. Patients were given i.v. bromodeoxyuridine and proliferation parameters were obtained using flow cytometry. The treatment protocol consisted of radiation therapy (XRT) (24 Gy/12-3.5 week split-28 Gy/14) and concurrent 5-fluorouracil and mitomycin C. Proliferation parameters were not obtained in six patients, leaving 26 patients in the analysis. There were 16 females and ten males, with two T1, 16 T2, five T3 and three T4 lesions. Median follow-up was 3.6 years. There were 22 squamous cell and four basaloid carcinomas. Six tumors were aneuploid.
  
  
  RESULTS
  Median values for T(s) and S-phase fraction were 7.7 h and 8.2%, respectively. The median LI was 6.8% (0.9-35.7%), and the median T(pot) was 4.1 days (0.9-30 days). There was no correlation of LI or T(pot) with gender, age, tumor stage, size or histology. Local failure was observed in five patients (T(pot)>4.1 days, n=3; LI>6.8%, n=4). Isolated regional failure or distant disease in the absence of local failure was not observed. The small number of outcome events precluded a definitive analysis of the prognostic role of LI and T(pot). Values for the proliferation parameters were similar to those in our updated study of patients with carcinoma of the uterine cervix (n=107), median LI of 6.7% and median T(pot) of 5.5 days.
  
  
  CONCLUSIONS
  We conclude that proliferation parameters in anal carcinomas are similar to those in cervical carcinomas. Rapid tumor proliferation does not have an apparent adverse impact on outcome in anal carcinomas managed by split-course XRT with concurrent 5-florouracil and mitomycin C.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronro, Ontario M5G 2M9, Canada.
authors.forename: C S
authors.initials: CS
authors.lastname: Wong
authors.forename: R W
authors.initials: RW
authors.lastname: Tsang
authors.forename: B J
authors.initials: BJ
authors.lastname: Cummings
authors.forename: A W
authors.initials: AW
authors.lastname: Fyles
authors.forename: J
authors.initials: J
authors.lastname: Couture
authors.forename: J D
authors.initials: JD
authors.lastname: Brierley
authors.forename: M
authors.initials: M
authors.lastname: Pintilie
mesh_terms: D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D002455:Cell Division; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology