Analysis of a follow-up program for anal canal carcinoma

The ideal follow-up program for anal canal cancer remains unclear and contr oversial. We hereby describe an extensive follow-up program for anal canal carcinoma in order to evaluate which examinations and which diagnostic tech niques really had impact on survival and management. We evaluated 25 patien ts with anal canal carcinoma. Local excision (LE) was performed in 5 patien ts, radiochemotherapy (RCT) in 13, radiochemotherapy and local excision (RC TE) in 7. Mean follow-up time was 6.3 years (range 20 months-ii years). The follow-up program included clinical examination, serum tumor markers evalu ation, transrectal ultrasonography (TRUS), anoscopy with either mucosal or by Tru-cut needle multiple biopsies, standard chest X-ray and hepatic-ingui nal ultrasonography, endoanal magnetic resonance imaging and in some cases total-body skeletal scintigraphy. A large multicentered randomized and pros pective trial is surely lacking and should be undertaken as soon as possibl e. Our results suggest that an effective local control, rather than a highe r survival is the reachable goal at present for anal canal carcinomas. Howe ver, further steps should be made to achieve better results. After this exp erience we propose a more semplified follow-up protocol which consists in p erforming only rectal examination, endoscopy, Tru-cut needle biopsies and T RUS for local control and inguinal ultrasound and TC to evidence distant me tastases.