Management of epidermoid carcinoma of the anus

In two unselected, consecutive and population-based patient materials from two regions in Sweden, different treatment modalities in patients with epidermoid carcinoma of the anus have been evaluated. By using a primary radiotherapeutic approach, combined with surgery in patients with large and/or less radiosensitive tumours, considerably more surviving patients can be disease-free in the long term compared with a primarily surgical approach. In addition, several patients will have preserved anal function. Based upon these data together with the experience described in the literature, we conclude that surgery is no longer the primary treatment of choice in patients with anal carcinoma.