Epidermoid Carcinoma of the Anal Canal

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Abstract
Epidermoid cancer of the anal canal is uncommon and occurs in the portion of the anus that runs from the anorectal ring to the anal verge. These tumors cause bleeding and pain and almost all can be identified by visual, digital, or anoscopic exam. Current initial treatment uses combination chemoradiotherapy. The radiotherapy entails 30 Gy (given over 3 to 4 weeks) using apposed fields with an additional boost of 15 to 20 Gy delivered to sites of macroscopic disease. Chemotherapy is given at the same time as the radiotherapy according to the following scheme: intravenous 5-FU (1000 mg/m2/day) on day 1 to 5 and day 31 to 35 and mitomycin C (15 mg/m2) on day 1. Patients undergo an evaluation to include visual inspection of the lesion site 1 month after completion of the radiotherapy. Any suspicious finding warrants a biopsy. Following chemoradiation, patients are examined every 3 months for the first 2 years, every 6 months for year 3 to 4, and yearly thereafter. An abdominoperineal resection or, in highly selected situations, additional chemoradiotherapy is offered to those patients with residual or recurrent disease following chemoradiation.

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