CONSERVATIVE MANAGEMENT OF SQUAMOUS-CELL CARCINOMA OF THE ANAL-CANAL

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 t reated at a single institution over a 10 year period, during which thi s approach has become the mainstay of therapy. Of the 34 patients trea ted 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 ove rall survival was 81%. The overall survival was superior to that in pa tients treated with radiotherapy alone. Eighty-four per cent of patien ts received the treatment as planned, while the remainder had a reduct ion in the dose of radiation or chemotherapy due to acute toxicity. Th e 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 ma nagement of patients with anal carcinoma.