[Epidermoid carcinoma of the anal canal. Value of a multidisciplinary approach]

Great progress has been achieved in the clinical diagnosis, the pathologic patterns study and the treatment of anal epidermoid carcinomas. External and interstitial radiotherapy in association with chemotherapy offers today a real chance to cure these lesions and to save sphincter function. Incidence in actinic lesions is reduced. Salvage abdominoperineal excision is still possible in case of local recurrence without delay in wound healing. 95 cases of anal epidermoid carcinoma were treated in the University cantonal Hospital of Geneva by a combined radio-chemotherapy approach. Local control has been achieved in 86% of tumors less than 4 cm in diameter and 73% of tumors more than 4 cm in diameter. Salvage abdomino-perineal excision has been required in 10% of cases. Abdomino-perineal excision is no more the first treatment of choice of anal epidermoid carcinoma.