[Characteristics of anal carcinoma with therapeutic consequences]

Anal cancers have to be looked at either as cancers of the anal canal or those of the anal margin. During the past years, evidence has been obtained that human papilloma virus (HPV) contributes to the formation of cancers, particularly in homo-sexual males. Surgical treatment alone, may only be considered in tumors with less than 2 cm in size. Combined radio-chemotherapy (RCT) using 45 Gy of RT + 5-FU/Mitomycin C is the treatment of choice with superiority to RT alone proven in randomized trials. Abdominoperineal excision is indicated only in case of a tumor recurrence or with stable disease or progression after RCT. Multimodal treatment after discussion in an experienced tumor board may result in recurrence-free and colostomy-free survival at 5 years in up to 80% of our patients.