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Epidermoid carcinoma of the anal canal

Results of treatment by combined chemotherapy and radiation therapy

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Thirty consecutive patients with epidermoid carcinomas of the anal canal larger than 2 cm were treated with the concomitant application of radiation and two cycles of chemotherapy (5FU and mitomycin-C) between January 1982 and January 1988. Twenty-eight patients were treated with curative intention and two for palliation only. All patients were reexamined after a period of one to 2 months, under light general anesthesia, and any residual tumor or scar tissue was biopsied. Control biopsy was positive in eight patients. Three of six patients who had abdominoperineal excision died from locoregional recurrence; the remaining are alive and cancer free after 1 to 4 years. Two patients had local excision; one is alive and the other died of other cancer metastasis four years later. Seventeen patients who had negative biopsies are alive and free of disease after 1 to 5 years; two died of unrelated causes, two died with distant metastasis (present prior to treatment), and one died with locoregional recurrence. Locoregional failures occurred in four patients (13.3 percent) in the entire series. Individualization of each patient, adjustment of doses, and carefully executed radiation and chemotherapy are the most important points for the success of treatment.

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References

  1. Boman BM, Moertel CG, O'Connell MJ, et al. Carcinoma of the anal canal: a clinical and pathologic study of 188 cases. Cancer 1984;54:114–25.

    Article  PubMed  CAS  Google Scholar 

  2. Greenall MJ, Quan SH, Stearns MW, Urmacher C, DeCosse JJ. Epidermoid cancer of the anal margin. Am J Surg 1985;149: 95–101.

    Article  PubMed  CAS  Google Scholar 

  3. Stearns MW Jr, Urmacher C, Sternberg SS, Woodruff J, Attiyeh F. Cancer of the anal canal. In: Hickey RC, ed. Curr Probl Cancer. Chicago: Year Book Medical Publishers, 1980;1–44.

    Google Scholar 

  4. Frost DB, Richards PC, Montague ED, Giacco GG, Martin RG. Epidermoid cancer of the anorectum. Cancer 1984;53:1285–93.

    Article  PubMed  CAS  Google Scholar 

  5. Pyper PC, Parks TG. The results of surgery for epidermoid carcinoma of the anus. Br J Surg 1985;72:712–4.

    Article  PubMed  CAS  Google Scholar 

  6. 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.

    Article  PubMed  CAS  Google Scholar 

  7. Golden GT, Horsley JS III. Surgical management of epidermoid carcinoma of the anus. Am J Surg 1973;131:275–80.

    Article  Google Scholar 

  8. Gordon-Watson C. The radium treatment of malignant disease of the rectum and anus. Proc R Soc Med 1935;28:53–9.

    Google Scholar 

  9. Papillon J, Montbarbon JF. Epidermoid carcinoma of the anal canal: a series of 276 cases. Dis Colon Rectum 1987;30:324–33.

    Article  PubMed  CAS  Google Scholar 

  10. Cummings BJ. The place of radiation therapy in the treatment of carcinoma of the anal canal. Cancer Treat Rev 1982;9:125.

    Article  PubMed  CAS  Google Scholar 

  11. Cantril ST, Green JP. Primary radiation therapy in the treatment of anal carcinoma. Int J Radiat Oncol Biol Phys 1983;9:1271–8.

    PubMed  CAS  Google Scholar 

  12. James RD, Pointon RS, Martin S. Local radiotherapy in the management of squamous carcinoma of the anus. Br J Surg 1985;72:282–5.

    Article  PubMed  CAS  Google Scholar 

  13. Nigro ND, Vaitkevicius VK, Considine B Jr. Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 1974;17:354–356.

    Article  PubMed  CAS  Google Scholar 

  14. Nigro ND, Vaitkevicius VK, Buroker T, Bradley GT, Considine B. Combined therapy for cancer of the anal canal. Dis Colon Rectum 1981;24:73–5.

    PubMed  CAS  Google Scholar 

  15. Quan SH. Anal and para-anal tumors. Surg Clin North 1978;58: 591–603.

    CAS  Google Scholar 

  16. Buroker TR, Nigro N, Bradley G, et al. Combined therapy for cancer of the anal canal. A follow-up report. Dis Colon Rectum 1977;20:677–8.

    Article  PubMed  CAS  Google Scholar 

  17. Michaelson RA, Magill GB, Quan SH, Leaming RH, Nikrui M, Stearns MW. Preoperative chemotherapy and radiation therapy in the management of anal epidermoid carcinoma. Cancer 1983;51:390–5.

    Article  PubMed  CAS  Google Scholar 

  18. Cummings BJ, Keane T, Thomas G, Harwood A, Rider W. Results and toxicity of the treatment of anal canal carcinoma by radiation therapy or radiation therapy and chemotherapy. Cancer 1984;54:2062–8.

    Article  PubMed  CAS  Google Scholar 

  19. Leichman L, Nigro N, Vaitkevicius VK, et al. Cancer of the anal canal: model for preoperative adjuvant combined modality therapy. Am J Med 1985;78:211–5.

    Article  PubMed  CAS  Google Scholar 

  20. Meeker WR, Sickle-Santanello BJ, Philpott G, et al. Combined chemotherapy radiation and surgery for epithelial cancer of the anal canal. Cancer 1986;57:525–9.

    Article  PubMed  Google Scholar 

  21. Smith DE, Muff NS, Shetabi H. Combined preoperative neoadjuvant radiotherapy and chemotherapy for anal and rectal cancer. Am J Surg 1986;151:577–80.

    Article  PubMed  CAS  Google Scholar 

  22. Harmer MH, ed. TNM classification of malignant tumors. Geneva: Union Internationale Controle le Cancer, 1976.

    Google Scholar 

  23. Morson BC, ed. International histological classification of tumors, no 15. Geneva: WHO, 1976.

    Google Scholar 

  24. Nigro ND, Seydel G, Considine B, Vaitkevicius VK, Leichman L, Kinzie JJ. Combined preoperative radiation and chemotherapy for squamous cell carcinoma of the anal canal. Cancer 1983;51:1826–9.

    Article  PubMed  CAS  Google Scholar 

  25. Dougherty BG, Evans HL. Carcinoma of the anal canal. Am J Clin Pathol 1985;83;159–64.

    PubMed  CAS  Google Scholar 

  26. Dillard BM, Spratt JS Jr, Ackerman LV, Butcher HR. Epidermoid cancer of anal margin and canal. Arch Surg 1963;86:100–105.

    Google Scholar 

  27. Beahrs H, Wilson SM. Carcinoma of the anus. Am Surg 1976;184: 422–8.

    CAS  Google Scholar 

  28. Welch JP, Malt RA. Appraisal of the treatment of carcinoma of the anus and anal canal. Surg Gynecol Obstet 1977;145:837–41.

    PubMed  CAS  Google Scholar 

  29. Swenson EW, Montague ED. Results of treatment in transitional cloacogenic carcinoma. Cancer 1980;46:828–30.

    Article  Google Scholar 

  30. O'Brien PH, Jenrette JM, Wallace KM, Metcalf JS. Epidermoid carcinoma of the anus. Surg Gynecol Obstet 1982;155:45–51.

    Google Scholar 

  31. Ramming KP, Juillard G, Parker R, Eilber F. Management of carcinoma of the rectum and anus without abdominoperineal resection. Am J Surg 1986;152:16–20.

    Article  PubMed  CAS  Google Scholar 

  32. Stearns MW Jr, Quan SH. Epidermoid carcinoma of the anorectum. Surg Gynecol Obstet 1970;131:953–7.

    PubMed  Google Scholar 

  33. Ager P, Samala E, Bosworth J, Rubin M, Ghossein NA. The conservative management of anorectal cancer by radiotherapy. Am J Surg 1979;137:228–30.

    Article  PubMed  CAS  Google Scholar 

  34. Papillon J, Mayer M, Montbarbon JF, Gerard JP, Chassard JL, Bailly C. A new approach to the management of epidermoid carcinoma of the anal canal. Cancer 1983;51:1830–7.

    Article  PubMed  CAS  Google Scholar 

  35. Salmon RJ, Fenton J, Asselain B, et al. Treatment of epidermoid anal canal cancer. Am J Surg 1984;147:43–8.

    Article  PubMed  CAS  Google Scholar 

  36. Greenall MJ, Quan SH, DeCosse JJ. Epidermoid cancer of the anus. Br J Surg 1985; Suppl. September S97-S103.

    Article  Google Scholar 

  37. Flam MS, John MJ, Mowry PA, Lovalvo LJ, Ramalho LD, Wade J. Definitive combined modality therapy of carcinoma of the anus: a report of 30 cases including results of salvage therapy in patients with residual disease. Dis Colon Rectum 1987;30:495–502.

    Article  PubMed  CAS  Google Scholar 

  38. Sischy B. The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum. Int J Radiat Oncol Biol Phys 1985;11:1587–93.

    PubMed  CAS  Google Scholar 

  39. Green JP, Schaupp WC, Cantril ST, Schall G. Anal carcinoma: current therapeutic concepts. Am J Surg 1980;140:151–5.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Hospital das Clínicas of the University of São Paulo, São Paulo, Brazil

    Angelita Habr-Gama M.D., Afonso H. da Silva e Sousa Jr. M.D., Wladimir Nadalin M.D., René Gansl M.D., José Hyppólito da Silva M.D. & Henrique Walter Pinotti M.D.

Authors
  1. Angelita Habr-Gama M.D.
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  2. Afonso H. da Silva e Sousa Jr. M.D.
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  3. Wladimir Nadalin M.D.
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  4. René Gansl M.D.
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  5. José Hyppólito da Silva M.D.
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  6. Henrique Walter Pinotti M.D.
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Additional information

Read at the meeting of the American Society of Colon and Rectal Surgeons, Anaheim, California, June 12 to 17, 1988.

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Habr-Gama, A., da Silva e Sousa, A.H., Nadalin, W. et al. Epidermoid carcinoma of the anal canal. Dis Colon Rectum 32, 773–777 (1989). https://doi.org/10.1007/BF02562127

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  • DOI: https://doi.org/10.1007/BF02562127

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