title: Anus-preservation treatment for anal cancer: retrospective analysis at a single institution.
abstract: BACKGROUND
  To evaluate anus-preservation treatment for anal cancer.
  
  
  METHODS
  Review of 42 patients (24 M/18 F; median age, 70 years; range, 13-95) with stage I-IIIB disease (squamous cell carcinoma [SqCC], 33; adenocarcinoma, 9) who received curative radiotherapy between 1991 and 2004. Eleven patients had prior surgical excision. Radiotherapy comprised lower-pelvis irradiation with boost to primary tumor (median lower-pelvis dose, 45 Gy; range, 17.2-59; median primary-site dose, 56 Gy; range, 40-72). Of 31 patients receiving concurrent chemoradiotherapy, 25 received 5-fluorouracil/mitomycin-C.
  
  
  RESULTS
  Median follow-up was 32 months. The most common toxicity was dermatological; 25 patients (59%) developed moderate-to-severe wet desquamation. Radiotherapy was interrupted in 18 patients (43%). The complete response rate was 67% (SqCC, 23/33; adenocarcinoma, 5/9); of 12 patients who failed treatment, primary tumor was the recurrent site in seven (median failure time, 5 months): six patients underwent salvage abdominoperineal resection. Three-year overall (OS) and disease-free survival (DFS) were 53% and 64%. Five-year functional anus-preservation rate was 64%. In multivariate analysis, OS was affected by performance status (P < 0.001), N stage (P = 0.009), and pathological type (P = 0.006). Only N stage (P = 0.001) affected DFS.
  
  
  CONCLUSIONS
  With careful monitoring of toxicity, non-surgical anus-preservation treatment with good tumor control is feasible.
authors.affiliation: Cancer Center, Taipei Veterans General Hospital & Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Sang-Hue
authors.initials: SH
authors.lastname: Yen
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Chen
authors.forename: Pin-I
authors.initials: PI
authors.lastname: Huang
authors.forename: Cheng-Ying
authors.initials: CY
authors.lastname: Shiau
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Liu
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Ling-Wei
authors.initials: LW
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin; D005472:Fluorouracil