Anal cancers. Squamous and melanoma

Area of Science:

• Oncology
• Gastroenterology

Background:

• Squamous cell carcinoma and malignant melanoma are distinct types of anal cancer.
• Squamous cell carcinoma is more prevalent and requires specific management based on anatomical location (anal margin vs. anal canal).

Purpose of the Study:

• To review the experience with squamous cell carcinoma and malignant melanoma of the anus.
• To highlight the evolution of treatment strategies for anal canal squamous cell carcinoma.
• To discuss salvage options for malignant melanoma of the anus.

Main Methods:

• Retrospective review of patient cases at Memorial Sloan-Kettering Cancer Center.
• Analysis of treatment outcomes for squamous cell carcinoma and malignant melanoma.
• Comparison of historical surgical management with current chemoirradiation and surgical approaches.

Main Results:

• Squamous cell carcinoma is the more common anal cancer.
• Anatomical distinction is crucial for managing squamous cell carcinoma of the anal margin versus the anal canal.
• Current chemoirradiation followed by surgery has improved 5-year survival rates and rectal salvage for anal canal squamous cell carcinoma.
• Malignant melanoma, though rare, remains occasionally salvageable with abdominoperineal resection.

Conclusions:

• Treatment for anal squamous cell carcinoma has advanced, improving patient outcomes.
• Multimodality treatment (chemoirradiation and surgery) is effective for anal canal squamous cell carcinoma.
• Radical surgery remains a key option for rare cases of anal malignant melanoma.