Abstract
The study of 54 patients treated curatively by irradiation with or without surgery is reported. The crude and cancer-specific five-year survival rates are 59.2 percent and 79.7 percent. Three patients were treated palliatively. The great variation in histologic type, clinical appearance, disease stage, and patient status justifies the definition of a treatment strategy using radiotherapy, surgery, or a combination of the two methods. T1 and T2 squamous-or basal-cell carcinomas are suitable for local excision followed by irradiation or for irradiation alone. T3 tumors and Bowen's disease should be treated by irradiation first. Verrucous carcinoma is suitable for local surgery followed by irradiation. Mucoepidermoid carcinoma and T4 tumors are suitable for preoperative irradiation and delayed surgery. The optimal radiation technique consists of delivering a dose of 40 Gy in 17 days by cobalt-60 with bolus and in combination with concomitant chemotherapy (5-fluorouracil and mitomycin C). Prophylactic irradiation of the inguinal area is recommended in all NO tumors except for T1 lesions and basal-cell carcinomas.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Strauss RJ, Fazio VW. Bowen's disease of the anal and perianal area: a report and analysis of twelve cases. Am J Surg 1979;137:231–4.
Papillon J. Rectal and anal cancers. Conservative treatment by irradiation—an alternative to radical surgery. New York: Springer Verlag, 1982.
Papillon J, Renard L, Pipard G. Le cancer de la marge de l'anus. Expérience du Centre Léon Bérard. J Eur Radiother (Paris) 1985;6:29–34.
Nigro N. Multidisciplinary management of cancer of the anus. World J Surg 1987;11:446–51.
Hermanek P, Sobin LH. TNM classification of malignant tumours. 4th ed. New York: Springer Verlag, 1987:50–2, 83–8.
American Joint Committee on Cancer. Manual for staging of cancer. 3rd ed. Philadelphia: JB Lippincott, 1987.
Beahrs OH, Wilson SM. Carcinoma of the anus. Ann Surg 1976;184:422–8.
Al-Jurf AS, Turnbull RB, Fazio VW. Local treatment of squamous cell carcinoma of the anus. Surg Gynecol Obstet 1979;148:576–9.
Nielsen OV, Jensen L. Basal cell carcinoma of the anus. A clinical study of 34 cases. Br J Surg 1981;68:856–7.
Jensen SL, Hagen K, Harling H, Shokouh-Amiri MH, Nielsen OV. Long-term prognosis after radical treatment for squamous-cell carcinoma of the anal canal and anal margin. Dis Colon Rectum 1988;31:273–8.
Schraut WH, Wang CH, Dawson PJ, Block GE. Depth of invasion location and size of cancer of the anus dictate operative treatment. Cancer 1983;51:1291–6.
Greenall MJ, Quan SH, Stearns MW, Urmacher C, DeCosse JJ. Epidermoid cancer of the anal margin. Pathologic features, treatment and clinical results. Am J Surg 1985;149:95–101.
Pinna Pintor M, Northover JM, Nicholls RJ. Squamous cell carcinoma of the anus at one hospital from 1948 to 1984. Br J Surg 1989;76:806–10.
Cutuli B, Fenton J, Labib A, Bataini JP, Mathieu G. Anal margin carcinoma: 21 cases treated at the Institut Curie by exclusive conservative radiotherapy. Radiother Oncol 1988;11:1–6.
Nigro ND, Vaitkevicius VK, Considine B Jr. Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 1974;17:354–6.
Glimelius B, Pahlman L. Radiation therapy of anal epidermoid carcinoma. Int J Radiat Oncol Biol Phys 1987;13:305–12.
Cummings BJ, Keane TJ, Hawkins NV, O'Sullivan B. Treatment of perianal carcinoma by radiation (RT) or radiation plus chemotherapy (RTCT). Int J Radiat Oncol Biol Phys 1986;12:170–3.
Author information
Authors and Affiliations
About this article
Cite this article
Papillon, J., Chassard, J.L. Respective roles of radiotherapy and surgery in the management of epidermoid carcinoma of the anal margin. Dis Colon Rectum 35, 422–429 (1992). https://doi.org/10.1007/BF02049397
Issue Date:
DOI: https://doi.org/10.1007/BF02049397