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

Administration of mitomycin C, 5-fluorouracil, and radiotherapy greatly reduced gross tumor sizes preoperatively in nine of ten patients who had epidermoid carcinoma of the anus and anorectum. In four of the cases there was no microscopic evidence of residual cancer in the resected specimens following this management and five specimens showed only histologic evidence of tumor. Because of these findings, we are encouraged to do more local excisions for cure whenever feasible, rather than doing abdominoperineal resection for this disease. Ultimately only accumulated time and continued experience will 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.