Multidisciplinary preoperative approach to the management of epidermoid carcinoma of the anus and anorectum

Abstract

Administration of mitomycin C, 5-fluorouracil and radiotherapy greatly reduced gross tumor sizes preoperatively in 9 of 10 patients who had epidermoid carcinoma of the anus and anorectum. In 4 of the cases there was no microscopic evidence of residual cancer in the resected specimens following this management and 5 specimens showed only histologic evidence of tumor. Because of these findings encouragement was given to do more local excisions for cure whenever feasible rather than doing abdominoperineal resection for this disease. Only accumulated time and continued experience determine the efficacy of approach in which preoperative multidisciplinary treatment is followed by more conservative surgical treatment of epidermoid carcinoma of the anus and anorectum.