APPRAISAL OF TREATMENT OF CARCINOMA OF ANUS AND ANAL-CANAL

Abstract

Anal bleeding and pain were the symptoms in half of 53 patients with carcinoma within and around the area of the anus treated from 1950-1974. Twenty-seven carcinomas were exclusively located in the anal canal and 6, in the perianal skin. Vaginal invasion was present in 13 women. There were 39 sqamous cell carcinomas and 9 basaloid cell carcinomas. More than 37 patients had an abdominoperineal resection as part of the treatment. The resection margins were positive for carcinomas in 11 patients. Radiation as the primary treatement was used only once. Palpably enlarged inguinal lymph nodes were treated by subsequent radical groin dissection. The crude over-all survival rate was 42%. The adjusted 5 yr survival rate was 38%. Significant correlates of death were symptoms for longer than 6 mo. duration, bleeding, inguinal adenopathy and presence of hemorrhoids. Abdominoperineal resection is the operation of choice for carcinoma of the anal verge or anal canal. Inguinal lymphadnectomy at a later time should be reserved for patients with signs of metastases to the inguinal nodes.