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Multimodality approach to surgical management of locally advanced epidermoid carcinoma of the anorectum
Author(s) -
Wanebo Harold J.,
Futrell William,
Constable William
Publication year - 1981
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19810615)47:12<2817::aid-cncr2820471211>3.0.co;2-h
Subject(s) - medicine , groin , epidermoid carcinoma , radiation therapy , surgery , chemotherapy , dissection (medical) , radiology , metastasis , cancer
Seven patients (five female, two male) had locally advanced epidermoid carcinoma of the anal canal. Three patients had recurrent or persistent disease previously treated and four had advanced primary cancer. Five patients had groin node metastasis. The treatment protocol consisted of chemotherapy with continuous 5‐day infusion of 5‐fluorouracil, 750 mg/m 2 , and mitomycin C, 15 mg/m 2 , by bolus injection and radiation 3000 rads. All patients received one or two cycles of chemotherapy preoperatively and four (not previously irradiated) received radiation. Tumor regression >50% occurred in five patients, minor regression (25–50%) occurred in one patient and one patient showed no regression (on chemotherapy alone). All patients had total resection of all gross tumor with microscopic clear margins and five had groin dissection. One patient had no residual cancer in specimen and one patient had a microscopic focus only. Four of five patients had residual nodal metastases at groin dissection. Currently three patients are free of disease at 24, 24, and 26 months. Two patients died with disease at 6 months and 34 months, and two patients died of other causes while still free of disease, at 4 and 5 months after resection. Multimodality therapy of locally advanced epidermoid cancer of anal canal can provide effective control and palliation of many of these tumors and, in some, possibly effect cure.