Carcinoma of the anal region

Longer follow up and greater numbers of patients will be required to determine the ultimate curative potential of surgery sparing regimens. Current reports suggest that combination chemotherapy and radiotherapy is equivalent to abdominoperineal resection. Furthermore, the incidence of local recurrence in most series suggests that abdominoperineal resection alone may be insufficient for locoregional control of disease. Patients with canal tumors who develop recurrent disease to inguinal nodes should be treated by groin dissection. Local recurrence of tumors at the anal margin can be satisfactorily treated by further local excision or by groin dissection if there are inguinal node metastases. Further studies are needed to evaluate the efficacy of chemotherapy and irradiation in pelvic recurrence following abdominoperineal resection. Further clinical trials to develop more effective salvage therapy in visceral metastatic disease are needed.