ANAL-CANAL AND PERIANAL EPIDERMOID CANCERS

Squamous cell carcinoma of the anal canal serves as a paradigm for the successful application of multimodality treatment of solid tumors. Si nce 1974, multimodality treatment with combined radiation and chemothe rapy has become the standard. The compelling advantage of sphincter pr eservation and the substantial survival benefit compared with surgery alone prompted investigators to adopt chemoradiation treatment. Severa l questions regarding the optimal radiation dose and chemotherapy in i nitial as well as salvage therapy remain, and only recently have resul ts of several prospective randomized studies become available to addre ss some of these unresolved issues. We reviewed the clinical aspects a nd historical treatment results of anal canal and perianal epidermoid cancers in light of the results of these modern trials. Current manage ment strategies are redefined, and future directions of clinical studi es are outlined. (C) 1997 by the American College of Surgeons).