[Epidermoid cancers of the anal canal]

Abstract

The frequency of anal epidermoid carcinoma is constantly increasing. Despite the fact that such cancers are easily detectable through rectal examination, anuscopy or biopsy, diagnosis is delayed in 30 to 50% of the cases due to late and unspecific clinical features, often mistaken for benign lesions. Prognosis of anal epidermoid carcinoma has radically improved due to a better knowledge of the tumour's natural history and of its spreading, to new stage classification (UICC-TNM) and to association fo external or interstitial radiotherapy with chemotherapy. Recovery rates of 80% can be achieved nowadays, 75% of which being obtained with complete sphincter preservation. Subsequent actinic lesions are rare. Surgery is now essentially proposed in these cases of therapeutic failure and consists in a rectal excision. Treatment of such tumours requires a multidisciplinary approach and a close collaboration between surgeon, radiotherapist and oncologist.