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Management of early anal cancer: need for guidelines and standardisation

  • Original Article
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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The optimal management of early squamous cell carcinoma of the anal canal (AC) is yet to be determined. This study investigated current practice in the management of early AC.

Methods

A patterns of care survey was completed by Australian surgeons and radiation oncologists. Specific topics addressed were as follows: geographical location of practice, staging of disease, treatment approaches to T1N0 tumours and grade 3 anal intra-epithelial neoplasia (AIN3) lesions, radiotherapy planning, toxicities, follow-up and clinical trial involvement.

Results

Sixty-four responses were obtained. For the management of T1N0 disease, half the respondents recommended standard dose chemo-radiotherapy (CRT) and one third recommended wide local excision (WLE). For the management of AIN3, half recommended WLE while a quarter advocated observation.

Conclusions

This study reveals a significant variation in the management of early AC. The development of guidelines specific to the treatment of early AC could standardise treatment while further research is required to define the optimal management of T1N0 AC and AIN.

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Acknowledgements

Thank you to Mo Hammoud for constructing and managing the online survey. Thank you to General Surgeons Australia and the Royal Australian and New Zealand College of Radiologists, Faculty of Radiation Oncology for distributing the survey to their members.

Funding

The authors declare that no funding was received.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Michael P. Jones

  2. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia

    Michael P. Jones, Jarad Martin & Dianne O’Connell

  3. Department of Radiation Oncology, Chris O’Brien Lifehouse, Camperdown, NSW, Australia

    Susan Carroll

  4. Royal Prince Alfred Hospital, Camperdown, NSW, Australia

    Susan Carroll & Christopher Young

  5. Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia

    Jarad Martin

  6. St Vincent’s Hospital, Darlinghurst, NSW, Australia

    Richard Hillman

  7. Kirby Institute, University of New South Wales, Kensington, NSW, Australia

    Andrew Grulich & Isobel Mary Poynten

  8. Cancer Research Division, Cancer Council NSW, Woolloomooloo, NSW, Australia

    Dianne O’Connell

  9. Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia

    Dianne O’Connell

  10. The University of Sydney, Camperdown, NSW, Australia

    Christopher Young

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  1. Michael P. Jones
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Correspondence to Michael P. Jones.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required.

Ethical approval

The research related to human participants was in keeping with all relevant national regulations and institutional policies and was performed in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ ethics committee.

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Jones, M.P., Carroll, S., Martin, J. et al. Management of early anal cancer: need for guidelines and standardisation. Int J Colorectal Dis 32, 1719–1724 (2017). https://doi.org/10.1007/s00384-017-2913-6

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  • DOI: https://doi.org/10.1007/s00384-017-2913-6

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