title: Combined multimodal approach to the treatment of metastatic anal carcinoma: report of a case and review of the literature.
abstract: BACKGROUND
  We report on a patient with squamous cell anal carcinoma and liver metastases, who underwent multimodal treatment for cure, consisting of repeated partial hepatectomy in combination with chemoradiotherapy.
  
  
  METHODS
  A 54-year-old woman presented with squamous cell anal carcinoma and liver metastases. She was treated with a combination of chemoradiotherapy for the primary tumor and then underwent surgery for liver metastases. 2 and 5 years after presentation, the patient underwent repeated partial hepatectomies for recurrent liver disease. At present, 5 months after completing therapy and 71 months after the initial diagnosis, she is in good health with no evidence of disease.
  
  
  RESULTS
  Repeated partial hepatectomy led to prolonged survival in a patient with squamous cell anal carcinoma metastatic to the liver.
  
  
  CONCLUSIONS
  This is the first report of aggressive partial hepatectomy for recurrent liver metastases resulting from anal cancer. Based on our experience, we suggest that in selected patients repeated hepatectomy should be part of an aggressive multimodal treatment program with curative intent.
authors.affiliation: Department of Oncology, Ben-Gurion University of the Egev, Beer Sheva, Israel. Ritato@clalit.org.il
authors.forename: Margarita
authors.initials: M
authors.lastname: Tokar
authors.forename: Dmitri
authors.initials: D
authors.lastname: Bobilev
authors.forename: Svetlana
authors.initials: S
authors.lastname: Zalmanov
authors.forename: David B
authors.initials: DB
authors.lastname: Geffen
authors.forename: Shlomo
authors.initials: S
authors.lastname: Walfisch
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000628:therapy*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D011878:Radiotherapy / Q000379:methods; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents