| Abstract | PURPOSE: To investigate the clinical history, management, and pattern of recurrence of very early-stage anal canal cancer in a French retrospective survey. METHODS: The study group consisted of 69 patients with Stage Tis and T1 anal canal carcinoma < or =1 cm treated between 1990 and 2000 (12 were in situ, 57 invasive, 66 Stage N0, and 3 Stage N1). The median patient age was 67 years (range, 27-83 years). Of the 69 patients, 66 received radiotherapy (RT) and 3 with in situ disease were treated by local excision alone without RT. Twenty-six patients underwent local excision before RT (12 with negative and 14 with positive surgical margins). Of the 66 patients who underwent RT, 8 underwent brachytherapy alone (median dose, 55 Gy), 38 underwent external beam RT (median dose, 45 Gy) plus a brachytherapy boost (median boost dose, 20 Gy), and 20 underwent external beam RT alone (median dose, 55 Gy). RESULTS: Of the 69 patients, 68 had initial local control. Of the 66 patients treated by RT, 6 developed local recurrence at a median interval of 50 months (range, 13-78 months). Four patients developed local failure outside the initial tumor bed. Of the 3 patients with Tis treated by excision alone, 1 developed local recurrence. No relation was found among prior excision, dose, and local failure. The 5-year overall survival, colostomy-free survival, and disease-free survival rate was 94%, 85%, and 89%, respectively. The rate of late complications (Grade 1-3) was 28% and was 14% for those who received doses <60 Gy and 37% for those who received doses of > or =60 Gy (p = 0.04). CONCLUSION: Most recurrences occurred after a long disease-free interval after treatment and often outside the initial tumor site. These small anal cancers could be treated by RT using a small volume and moderate dose (40-50 Gy for subclinical lesions and 50-60 Gy for T1). |
| Authors | Cécile Ortholan, Alain Ramaioli, Didier Peiffert, Antoine Lusinchi, Pascale Romestaing, Laurent Chauveinc, Emmanuel Touboul, Karine Peignaux, Antoine Bruna, Guy de La Roche, Jean-Léon Lagrange, Christian Alzieu, Jean Pierre Gerard
(Affiliation: Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France. c.ortholan at wanadoo.fr)
|
| Journal | International journal of radiation oncology, biology, physics
(Int J Radiat Oncol Biol Phys)
Vol. 62
Issue 2
Pg. 479-85
(Jun 1 2005)
ISSN: 0360-3016 United States |
| PMID | 15890590
(Publication Type: Journal Article)
|
| Topics |
- Adult
- Aged
- Aged, 80 and over
- Anal Canal
(physiology)
- Anus Neoplasms
(pathology, radiotherapy, surgery)
- Carcinoma in Situ
(pathology, radiotherapy, surgery)
- Carcinoma, Squamous Cell
(pathology, radiotherapy, surgery)
- Carcinoma, Transitional Cell
(pathology, radiotherapy, surgery)
- Chi-Square Distribution
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Radiotherapy Dosage
|
