Anal carcinoma: histology, staging, epidemiology, treatment

Our understanding of the pathogenesis and management of squamous cell carcinoma of the anal canal has undergone profound change over the last 30 years. Epidemiologic studies have demonstrated that infection with human papillomavirus is most likely responsible for the majority of cases. Primary treatment with concomitant chemotherapy and radiation cures the majority of patients without the need for an abdominoperineal resection. Recent series have demonstrated that approximately one half of patients with a local recurrence after chemoradiation will be cured with salvage surgery. The incorporation of cisplatin into the primary chemoradiation treatment of patients with carcinoma of the anal canal is the focus of current studies.