The management of anal carcinoma

“…33,[45][46][47][48] This involved abdominoperineal resection (APR) with or without inguinal lymph node dissection. The overall five-year survival rate after radical surgery ranged between 30 and 71 percent, with an operative mortality between 2.5 and 5 percent.…”

Section: Radical Surgerymentioning

confidence: 99%

Management of Anal Canal Cancer

Sato

Koh

Bartolo

2005

Diseases of the Colon &Amp; Rectum

View full text Add to dashboard Cite

To improve treatment outcomes and reduce treatment-related toxicities, further studies are required to elucidate the optimal drug combination and doses, optimal radiation field, total dose, and fraction sizes. Randomized, multicenter trials are needed to define the treatment protocol that provides the highest rate of sphincter preservation with acceptable toxicity. Few studies addressed the treatment of metastatic disease, which remains a major cause of mortality.

show abstract

“…However, the early intra-pelvic spread of carcinoma of the anal canal prevented APE from achieving a high cure rate. 14 In our series, five of the six patients who received an APE as primary treatment for anal SCC achieved clear surgical margins without significant perioperative morbidity. In the largest series of APE for SCC Lefèvre et al analysed 105 cases.…”

Section: Resultsmentioning

confidence: 65%

Requiem for Nigro or is anal squamous carcinoma still a surgical problem: Abdominoperineal excision rather than a defunctioning stoma?

et al. 2018

View full text Add to dashboard Cite

Background: Combined multimodal treatment (CMT) is the preferred treatment for anal squamous carcinoma with radical surgery reserved for treatment failure. Some patients require a defunctioning stoma prior to CMT. Successful closure of such a stoma is unlikely. Abdominoperineal excision (APE) may be suitable as primary treatment in these patients. Objectives: To evaluate organ preservation in the treatment of anal squamous cancer and the closure rate of pre-treatment, temporary diverting colostomy, thereby assessing whether APE could be offered as primary treatment in those requiring a pre-treatment colostomy. Methods: A retrospective review of all patients with anal squamous carcinoma was undertaken. Patients who required defunctioning colostomies prior to CMT were analysed for potential resectability of tumour prior to CMT and rate of permanent stoma. Results: One hundred and twenty-five patients were included of which 58 were males. The mean age was 56 years. 107 were treated with curative intent. Six received primary APE and 12 salvage APE. Thirty (22 males) required pretreatment diverting colostomies. Three (10%) stomas were successfully reversed. Forty-eight (38%) of the 125 completed treatment with a permanent colostomy. Six patients who needed a stoma prior to CMT were deemed resectable. Conclusion: Organ preservation was not possible in about a third of patients. Defunctioning stomas prior to CMT were likely to be permanent. We propose that APE could be considered as an alternative in selective cases where the tumour is resectable with low morbidity and a stoma is indicated.

show abstract

The management of anal carcinoma

Cited by 16 publications

References 12 publications

Treatment of carcinoma of the anal canal at Groote Schuur Hospital

Treatment of carcinoma of the anal canal at Groote Schuur Hospital

Management of Anal Canal Cancer

Requiem for Nigro or is anal squamous carcinoma still a surgical problem: Abdominoperineal excision rather than a defunctioning stoma?

Contact Info

Product

Resources

About