title: Should the Surgical Management of Buschke-Lowenstein Tumors Be Aggressive? About 10 Cases.
abstract: OBJECTIVE
  Buschke-Lowenstein tumor (BLT) of the anal margin is a histologically benign tumor whose degeneration can lead to a deadly local evolution because of difficult and late diagnosis. The objective of this study was to report our experience and propose a therapeutic strategy for these rare tumors.
  
  
  METHODS
  From 1996 to 2014, 10 men with a median age of 45 years (25-64) were treated for a BLT of the anal margin with a first local excision possibly followed by rectal amputation.
  
  
  RESULTS
  Local perianal excision was curative in 6 cases without recurrence. The median follow-up time was 94.5 months (5-175). In 4 patients, local excision was followed by an early recurrence, justifying a complementary abdominoperineal excision (APE) of the rectum. Two patients who benefited from complementary resection are currently free from recurrence. Even if the postoperative course was uneventful, 2 died from recurrence and disease progression within 5 and 11 postoperative months each.
  
  
  CONCLUSIONS
  Macroscopic surgical evaluation of local tumoral invasion and extensive radical resection appears to be associated with long-term survival without recurrence. When recurrence occurs, APE of the rectum seems to be the only curative alternative. Based on low level of evidence, surgical excision is currently the only standard treatment for these lesions.
authors.affiliation: Department of Digestive and Colorectal Surgery, Edouard Herriot University Hospital, Lyon, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Fanget
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pasquer
authors.forename: Filbert
authors.initials: F
authors.lastname: Djeudji
authors.forename: Jacques
authors.initials: J
authors.lastname: Chabanon
authors.forename: Xavier
authors.initials: X
authors.lastname: Barth
mesh_terms: D000328:Adult; D001005:Anus Neoplasms / Q000473:pathology / Q000601:surgery*; D062688:Buschke-Lowenstein Tumor / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Abdominoperineal excision; Anus; Buschke-Lowenstein; Tumor