EPIDERMOID CARCINOMA OF THE ANAL MARGIN - 17 CASES TREATED WITH CURATIVE-INTENT RADIATION-THERAPY

Between 1973 and 1991, 17 patients with epidermoid carcinoma of the an al margin without evidence of distant metastasis were treated with cur ative-intent radiation therapy (RT). There were nine T1-tumors, six T2 -, one T3- and one T4-tumor;two patients presented with inguinal node involvement: one N1 and one N3. Nine patients underwent prior incomple te local excision (six with microscopic involvement of surgical margin s and two with macroscopic residual disease). The radiation dose to th e tumor was 60-70 Gy; the radiation dose to the inguinal lymph nodes w as 40-45 Gy in NO, and 50-60 Gy for involved inguinal nodes. The 5- an d 10-year cancer-specific survival rates were 86.2% and 77.5%, respect ively. The same probabilities were 100% and 100% for T1-tumors, 60% an d 40% for T2-tumors. Severe complications occurred in two patients, on e anal radionecrosis requiring a colostomy and one permanent anal inco ntinence after local excision. which was non-related to irradiation. F or the cured patients, the sphincter preservation rate after 5 years w as 82% (9/11). In univariate analysis and in Cox multivariate analysis , the cancer-specific survival rate was influenced by one factor: the tumor size.