CONSERVATIVE MANAGEMENT OF SQUAMOUS CELL CARCINOMA OF THE ANAL CANAL

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Abstract
The treatment of anal carcinoma with concurrent chemo/radiotherapy has largely replaced abdominoperineal resection as the primary management. This report details the outcome of 62 patients with anal carcinoma treated at a single institution over a 10 year period, during which this approach has become the mainstay of therapy. Of the 34 patients treated with combination radiotherapy and chemotherapy (5‐fluorouracil and mitomycin‐C), 31 were evaluable and a complete response was achieved in 77%. The estimated 5 year failure‐free survival was 67% and the overall survival was 81%. The overall survival was superior to that in patients treated with radiotherapy alone. Eighty‐four per cent of patients received the treatment as planned, while the remainder had a reduction in the dose of radiation or chemotherapy due to acute toxicity. The use of combination therapy for primary management of anal carcinoma is generally well tolerated, appears to provide a treatment outcome at least equivalent to surgery, and allows preservation of anal function. Concurrent chemo/radiotherapy should be considered in the initial management of patients with anal carcinoma.

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