Avaliação dos resultados do tratamento de 14 doentes de carcinoma espinocelular anal

Chemoradiation became the treatment of choice for anal squamous cells carcinoma (SCC). However, in local recurrence or residual disease, local resection or abdominoperineal resection must be performed. OBJECTIVE: the aim of this retrospective study was to analyze results of 14 patients treated for anal SCC. METHOD: Anal SCC was diagnosed in 17 patients. They were 14 (82.3%) females and three (17.8%) males with ages varying from 36 to 78 years old, and 59.1 years-old in mean. Using TNM classification, they were four (23.6%) class I, six (35.2%) class II, four (23.6%) class IIIa and three (17.6%) class IIIb. All patients were submitted prior to chemoradiation, except for one, in whom local resection was performed. We considered that negative biopsy, performed from 12 to 16 weeks after treatment, would define local control for disease. RESULTS: Three patients (17.6%) were lost in the follow-up. So, 14 (82.3%) were accompanied from one up to five years. All patients in I and II TNM class and three in IIIa and IIIb (75%) had complete tumor remission. We have performed anorectal amputation in two patients and local resection in other two patients. Local recurrence occurred in two I and II TNM class patients (20%) and in two IIIa and IIIb TNM class patients (50%). All patients in I and II class were alive after the third year, despite tumor control being obtained in eight patients. In IIIa and IIIb patients, survival after one year was seen in three (75%) and after the third year in just one (25%) patients that remain free from disease. No death occurred during chemoradiation. Two HIV-positive patients presented anal human papillomavirus infection. CONCLUSION: Our results showed that the treatment used was effective for local control, preserving anal function, and whenever chemoradiation fails, surgical treatment was effective to control this kind of cancer.

Anal carcinoma; Chemoradiation; Squamous cells carcinoma

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