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Anal Neoplasms

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Abstract

While anal neoplasms account for less than 5% of lower gastrointestinal tract malignancies and less than 1% of new malignancies overall in the United States, knowledge regarding the diagnosis and management of these lesions is critical to the practice of colon and rectal surgery. It is estimated that there will be 8200 new cases of anal cancer diagnosed in 2017, and an estimated 1100 deaths; both of these represent a continued slow upward trend in recent years. This chapter will outline the diagnosis and management of anal neoplasms, both malignant and pre-malignant.

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References

  1. Simpson JAD, Scholefield JH. Diagnosis and management of anal intraepithelial neoplasia and anal cancer. BMJ. 2011;343:d6818.

    Article  CAS  PubMed  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  PubMed  Google Scholar 

  3. Pineda CE, Welton ML. Management of anal squamous intraepithelial lesions. Clin Colon Rectal Surg. 2009;22:94–101.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chin JY, Hong TS, Wo JY. Anal cancer: current and future treatment strategies. Gastrointest Cancer Targets Ther. 2013;3:19–27.

    Google Scholar 

  5. Shridhar R, Shibata D, Chan E, Thomas CR. Anal cancer: current standards in care and recent changes in practice. CA Cancer J Clin. 2015;65:139–62.

    Article  PubMed  Google Scholar 

  6. Daling JR, Madeleine MM, Johnson LG, et al. Human papilloma virus, smoking, and sexual practices in the etiology of anal cancer. Cancer. 2004;101:270–80.

    Article  PubMed  Google Scholar 

  7. Shiels MS, Pfeiffer RM, Chaturvedi AK, et al. Impact of the HIV epidemic on the incidence rates of anal cancer in the United States. J Natl Cancer Inst. 2012;104:1591–8.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ryan DP, Compton CC, Mayer RJ. Carcinoma of the anal canal. N Engl J Med. 2000;342:782–800.

    Google Scholar 

  9. Osborne MC, Maykel J, Johnson EK, Steele SR. Anal squamous cell carcinoma: an evolution in disease and management. World J Gastroenterol. 2014;20:13052–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Tanum G, Tveit K, Karlsen KO. Diagnosis of anal carcinoma – doctor’s finger still the best. Oncology. 1991;48:383–6.

    Article  CAS  PubMed  Google Scholar 

  11. Samdani T, Nash GM. Anal cancer. In: Steele SR, Hull TL, Read TE, et al., editors. The ASCRS textbook of colon and rectal surgery. 3rd ed. Cham: Springer; 2016. p. 357–71.

    Chapter  Google Scholar 

  12. Billingham R. Neoplasms of the anus and the perianal skin. In: Mazier WP, Levien DH, Luchtefeld MA, Senegore AJ, editors. Surgery of the colon, rectum, and anus. Philadelphia: WB Saunders; 1995. p. 205–28.

    Google Scholar 

  13. NCCN clinical practice guidelines in oncology – anal carcinoma (version 1.2017 – November 23, 2016). Available from: https://www.nccn.org/professionals/physician_gls/pdf/anal.pdf. Accessed March 23, 2017.

  14. Bilimoria KY, Bentrem DJ, Rock CE, et al. Outcomes and prognostic factors for squamous-cell carcinoma of the anal canal: analysis of patients from the National Cancer Data Base. Dis Colon Rectum. 2009;52:624–31.

    Article  PubMed  Google Scholar 

  15. Kolev NY, Tonev AY, Ignatov VL, et al. The role of 3-D endorectal ultrasound in rectal cancer: our experience. Int Surg. 2014;99:106–11.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Granata V, Fusco R, Reginelli A, et al. Radiological assessment of anal cancer: an overview and update. Infect Agent Cancer. 2016;11:52.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Granata V, Fusco R, Catalano O, et al. Early assessment of colorectal cancer patients with liver metastases treated with antiangiogenic drugs: the role of intravoxel incoherent motion in diffusion-weighted imaging. PLoS ONE. 2015;10:e0142876.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Cotter SE, Grigsby PW, Siegel BA, et al. FDG-PET/CT in the evaluation of anal carcinoma. Int J Radiat Oncol Biol Phys. 2006;65:720–5.

    Article  PubMed  Google Scholar 

  19. Ed W, Heriot AG, Ng M, et al. The impact of 18-fluorodeoxyglucose positron emission tomography on the staging, management and outcome of anal cancer. Br J Cancer. 2009;100:693–700.

    Article  Google Scholar 

  20. Bhuva NJ, Glynne-Jones R, Sonoda L, et al. To PET or not to PET? That is the question. Staging in anal cancer. Ann Oncol. 2012;23:2078–82.

    Article  CAS  PubMed  Google Scholar 

  21. Caldarella C, Annunziata S, Treglia G, et al. Diagnostic performance of positron emission tomography /computed tomography using fluorine-18 fluorodeoxyglucose in detecting locoregional nodal involvement in patients with anal cancer: a systematic review and meta-analysis. Sci World J. 2014;2014:196068.

    Article  CAS  Google Scholar 

  22. Mistrangelo M, Pelosi E, Bellò M, et al. Role of positron emission tomography-computed tomography in the management of anal cancer. Int J Radiat Oncol Biol Phys. 2012;84:66–72.

    Article  PubMed  Google Scholar 

  23. Wells IT, Fox BM. PET/CT in anal cancer – is it worth doing? Clin Radiol. 2012;67:535–40.

    Article  CAS  PubMed  Google Scholar 

  24. Jones M, Hruby G, Solomon M, et al. The role of FDG-PET in the initial staging and response assessment of anal cancer: a systematic review and meta-analysis. Ann Surg Oncol. 2015;22:3574–81.

    Article  PubMed  Google Scholar 

  25. Nigro ND, Vaitkevicius VK, Considine B Jr. Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum. 1974;17:310–2.

    Article  PubMed  Google Scholar 

  26. Buroker TR, Nigro NM, Bradley G, et al. Combined therapy for cancer of the anal canal: a follow-up report. Dis Colon Rectum. 1977;20:677–8.

    Article  CAS  PubMed  Google Scholar 

  27. Nigro ND, Seydel HG, Considine B, et al. Combined preoperative radiation and chemotherapy for squamous cell carcinoma of the anal canal. Cancer. 1983;51:1826–9.

    Article  CAS  PubMed  Google Scholar 

  28. Nigro ND. Multidisciplinary management of cancer of the anus. World J Surg. 1987;11:446–51.

    Article  CAS  PubMed  Google Scholar 

  29. UKCCCR Anal Cancer Trial Working Party. Epidermoid anal cancer: results from the UKCCCR randomized trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Coordinating Committee on Cancer Research. Lancet. 1996;348:1049–54.

    Article  Google Scholar 

  30. Northover J, Glynne-Jones R, Sebag-Montefiore D, et al. Chemoradiation for the treatment of epidermoid anal cancer: 13-year follow-up of the first randomised UKCCCR Anal Cancer Trial (ACT I). Br J Cancer. 2010;102:1123–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Bartelink H, Roelofsen F, Eschwege F, et al. Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol. 1997;15:2040–9.

    Article  CAS  PubMed  Google Scholar 

  32. Flam M, John M, Pajak TF, et al. Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J Clin Oncol. 1996;14:2527–39.

    Article  CAS  PubMed  Google Scholar 

  33. Ajani JA, Winter KA, Gunderson LL, et al. Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial. JAMA. 2008;299:1914–21.

    Article  CAS  PubMed  Google Scholar 

  34. James RD, Glynne-Jones R, Meadows HM, et al. Mitomycin or cisplatin chemoradiation for treatment of squamous-cell carcinoma of the anus (ACT II): randomised, phase 3, open-label, 2 x 2 factorial trial. Lancet Oncol. 2013;14:516–24.

    Article  CAS  PubMed  Google Scholar 

  35. Peiffert D, Tournier-Rangeard L, Gerard JP, et al. Induction chemotherapy and dose intensification of the radiation boost in locally advanced anal carcinoma: final analysis of the randomised UNICANCER ACCORD 03 trial. J Clin Oncol. 2012;30:1941–8.

    Article  CAS  PubMed  Google Scholar 

  36. Rothenstein DA, Dasgupta T, Chou JF, et al. Comparison of outcomes of intensity-modulated radiotherapy and 3-D conformal radiotherapy for anal squamous cell carcinoma using a propensity score analysis. J Clin Oncol. 2011;29:2011.

    Article  Google Scholar 

  37. Yates A, Carroll S, Kneebone A, et al. Implementing intensity-modulated radiotherapy with simultaneous integrated boost for anal cancer: 3 year outcomes at two Sydney institutions. Clin Oncol. 2015;27:700–7.

    Article  CAS  Google Scholar 

  38. Van Damme N, Deron P, Van Roy N, et al. Epidermal growth factor receptor and K-RAS status in two cohorts of squamous cell carcinomas. BMC Cancer. 2010;10:189.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Deutsch E, Lemanski C, Pignon JP, et al. Unexpected toxicity of cetuximab combined with conventional chemoradiotherapy in patients with locally advanced anal cancer: results of the UNICANCER ACCORD 16 phase II trial. Ann Oncol. 2013;24:2834–8.

    Article  CAS  PubMed  Google Scholar 

  40. Kochhar R, Renehan AG, Mullan D, et al. The assessment of local response using magnetic resonance imaging at 3- and 6-month post chemoradiotherapy in patients with anal cancer. Eur Radiol. 2017;27:607–17.

    Article  PubMed  Google Scholar 

  41. Vercellino L, Montravers F, de Parades V, et al. Impact of FDG PET/CT in the staging and the follow-up of anal carcinoma. Int J Color Dis. 2011;26:201–10.

    Article  Google Scholar 

  42. Teagle AR, Gilbert DC, Jones JR, et al. Negative 18F-FDG-PET-CT may exclude residual or recurrent disease in anal cancer. Nucl Med Commun. 2016;37:1038–45.

    Article  CAS  PubMed  Google Scholar 

  43. Papaconstantinou HT, Bullard KM, Rothenberger DA, Madoff RD. Salvage abdominoperineal resection after failed Nigro protocol: modest success, major morbidity. Color Dis. 2006;8:124–9.

    Article  CAS  Google Scholar 

  44. Van der Wal BC, Cleffken BI, Gulec B, et al. Results of salvage abdominoperineal resection for recurrent anal carcinoma following combined chemoradiation therapy. J Gastrointest Surg. 2001;5:383–7.

    Article  PubMed  Google Scholar 

  45. Ghouti L, Houvenaeghel G, Moutardier V, et al. Salvage abdominoperineal resection after failure of conservative treatment in anal epidermoid cancer. Dis Colon Rectum. 2005;48:16–22.

    Article  PubMed  Google Scholar 

  46. Butler CE, Gündeslioglu AO, Rodriguez-Bigas MA. Outcomes of immediate rectus abdominus myocutaneous flap for reconstruction for irradiated abdominoperineal resection defects. J Am Coll Surg. 2008;206:694–703.

    Article  PubMed  Google Scholar 

  47. Hinojosa MW, Parikh DA, Menon R, et al. Recent experience with abdominal perineal resection with vertical rectus abdominus myocutaneous flap reconstruction after preoperative pelvic radiation. Am Surg. 2009;75:995–9.

    PubMed  Google Scholar 

  48. Chessin DB, Hartley J, Cohen AM, et al. Rectus flap reconstruction decreases perineal wound complications after pelvic chemoradiation and surgery: a cohort study. Ann Surg Oncol. 2005;12:104–10.

    Article  PubMed  Google Scholar 

  49. Devulapalli C, Jia Wei AT, DiBiagio JR, et al. Primary versus flap closure of perineal defects following oncologic resection: a systematic review and meta-analysis. Plast Reconstr Surg. 2016;137:1602–13.

    Article  CAS  PubMed  Google Scholar 

  50. Singh M, Kinsley S, Huang A, et al. Gracilis flap reconstruction of the perineum: an outcomes analysis. J Am Coll Surg. 2016;223:602–10.

    Article  PubMed  Google Scholar 

  51. Das P, Cantor SB, Parker CL, et al. Long-term quality of life after radiotherapy for the treatment of anal cancer. Cancer. 2010;116:822–9.

    Article  PubMed  Google Scholar 

  52. Joseph K, Vos LJ, Warkentin H, et al. Patient reported quality of life after helical IMRT based concurrent chemoradiation of locally advanced anal cancer. Radiother Oncol. 2016;120:228–33.

    Article  PubMed  Google Scholar 

  53. Sunesen KG, Nørgaard M, Lundby L, et al. Long-term anorectal, urinary and sexual dysfunction causing distress after radiotherapy for anal cancer: a Danish multicenter cross-sectional questionnaire study. Color Dis. 2015;17:O230–9.

    Article  CAS  Google Scholar 

  54. Bentzen AG, Balteskard L, Wanderàs EH, et al. Impaired health-related quality of life after chemoradiotherapy for anal cancer: late effects in a national cohort of 128 survivors. Acta Oncol. 2013;52:736–44.

    Article  PubMed  Google Scholar 

  55. Frisch M, Biggar RJ, Goedert JJ. Human papillomavirus-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome. J Natl Cancer Inst. 2000;92:1500–10.

    Article  CAS  PubMed  Google Scholar 

  56. Machalek DA, Poynten M, Jin F, et al. Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systemic review and meta-analysis. Lancet Oncol. 2012;13:487–500.

    Article  PubMed  Google Scholar 

  57. Chang GJ, Gonzales RJ, Skibber JM, et al. A twenty-year experience with adenocarcinoma of the anal canal. Dis Colon Rectum. 2009;52:1375–80.

    Article  PubMed  Google Scholar 

  58. Bertelson N, Blumetti J, Cintron J, et al. Anal adenocarcinoma: outcomes in an uncommon malignancy. Am Surg. 2015;81:1114–7.

    PubMed  Google Scholar 

  59. Chang AE, Kernell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998;83:1664–78.

    Article  CAS  PubMed  Google Scholar 

  60. Parra RS, de Almeida ALNR, Badiale GB, et al. Melanoma of the anal canal. Clinics. 2010;65:1063–5.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Zhong J, Zhou JN, Xu FP, Shang JQ. Diagnosis and treatment of anorectal malignant melanoma: a report of 22 cases with literature review. Ai Zheng. 2006;25:619–24.

    PubMed  Google Scholar 

  62. Garrett K, Kalady MF. Anal neoplasms. Surg Clin North Am. 2010;90:147–61.

    Article  PubMed  Google Scholar 

  63. Chen H, Cai Y, Liu Y, et al. Incidence, surgical treatment, and prognosis of anorectal melanoma from 1973 to 2011: a population-based SEER analysis. Medicine. 2016;95:e2770.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Brady MS, Kavolius JP, Quan SH. Anorectal melanoma. A 64 year experience at Memorial Sloan Kettering Cancer Center. Dis Colon Rectum. 1995;38:146–51.

    Article  CAS  PubMed  Google Scholar 

  65. Podnos YD, Tsai NC, Smith D, Ellenhorn JD. Factors affecting survival in patients with anal melanoma. Am Surg. 2006;72:917–20.

    PubMed  Google Scholar 

  66. Kiran RP, Rottoli M, Pokala N, Fazio VW. Long-term outcomes after local excision and radical surgery for anal melanoma: data from a population database. Dis Colon Rectum. 2010;53:402–8.

    Article  PubMed  Google Scholar 

  67. Metildi C, McLemore EC, Tran T, et al. Incidence and survival patterns of rare anal canal neoplasms using the surveillance epidemiology and end results registry. Am Surg. 2013;79:1068–74.

    PubMed  PubMed Central  Google Scholar 

  68. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Int J Surg Pathol. 2002;10:81–9.

    Article  PubMed  Google Scholar 

  69. Darier J, Coulillaud P. Concerning a case of Paget disease of the perineal and scrotal area. Ann Dermatol Syphiligr. 1893;4:25–33.

    Google Scholar 

  70. Kyriazanos ID, Stamos NP, Miliadis L, et al. Extra-mammary Paget’s disease of the perianal region: a review of the literature emphasizing the operative management technique. Surg Oncol. 2011;20:e61–71.

    Article  PubMed  Google Scholar 

  71. Berardi RS, Lee S, Chen HP. Perianal extramammary Paget’s disease. Surg Gynecol Obstet. 1988;167:359–66.

    CAS  PubMed  Google Scholar 

  72. Banerjee S, Chatterjee M, Chand K. Extramammary Paget’s disease. Indian J Dermatol Venereol Leprol. 2005;71:417–20.

    Article  PubMed  Google Scholar 

  73. Sahai A, Kodner IJ. Premalignant neoplasms and squamous cell carcinoma of the anal margin. Clin Colon Rectal Surg. 2006;19:88–93.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Beck DE, Fazio VW. Perianal Paget’s disease. Dis Colon Rectum. 1987;30:263–6.

    Article  CAS  PubMed  Google Scholar 

  75. Perez DR, Trakarnsanga A, Shia J, et al. Management and outcome of perianal Paget’s disease: a 6-decade institutional experience. Dis Colon Rectum. 2014;57:747–51.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Murakami K, Tanimura H, Ishimoto K, et al. Reconstruction with bilateral gluteus maximus rotation flap after wide local excision for perianal extramammary Paget’s disease. Report of two cases. Dis Colon Rectum. 1996;39:227–31.

    Article  CAS  PubMed  Google Scholar 

  77. Gaertner WB, Hagerman GF, Goldberg SM, Finne CO. Perianal Paget’s disease treated with wide excision and gluteal flap reconstruction: report of a case and review of the literature. Dis Colon Rectum. 2008;51:1842–5.

    Article  PubMed  Google Scholar 

  78. St Peter SD, Pera M, Smith AA, et al. Wide local excision and split-thickness skin graft for circumferential Paget’s disease of the anus. Am J Surg. 2004;187:413–6.

    Article  PubMed  Google Scholar 

  79. Marchesa P, Fazio VW, Oliart S, et al. Long-term outcome of patients with perianal Paget’s disease. Ann Surg Oncol. 1997;4:475–80.

    Article  CAS  PubMed  Google Scholar 

  80. McCarter MD, Quan SH, Busam K, et al. Long-term outcome of perianal Paget’s disease. Dis Colon Rectum. 2003;46:612–6.

    Article  PubMed  Google Scholar 

  81. Isik O, Aytac E, Brainard J, et al. Perianal Paget’s disease: three decades experience of a single institution. Int J Color Dis. 2016;31:29–34.

    Article  Google Scholar 

  82. Sarmiento JM, Wolff BG, Burgart LJ, et al. Paget’s disease of the perianal region – an aggressive disease? Dis Colon Rectum. 1997;40:1187–94.

    Article  CAS  PubMed  Google Scholar 

  83. Conklin A, Hassan I, Chua HK, et al. Long-term functional and quality of life outcomes of patients after repair of large perianal skin defects for Paget’s and Bowen’s disease. J Gastrointest Surg. 2009;13:951–5.

    Article  PubMed  Google Scholar 

  84. Mirer E, El Syaed F, Ammoury A, et al. Treatment of mammary and extramammary Paget’s skin disease with topical imiquimod. J Dermatolog Treat. 2006;17:167–71.

    Article  PubMed  Google Scholar 

  85. Vereecken P, Awada A, Ghanem G, et al. A therapeutic approach to perianal Paget’s disease: topical imiquimod can be useful to prevent or defer surgery. Med Sci Monit. 2007;13:CS75–7.

    PubMed  Google Scholar 

  86. Velenik V, Segedin B, Anderluh F, et al. Radiotherapy for perianal Paget’s disease: a case report. Tumori. 2008;94:750–3.

    Article  PubMed  Google Scholar 

  87. Hata M, Omura M, Koike I, et al. Role of radiotherapy as curative treatment of extramammary Paget’s disease. Int J Radiat Oncol Biol Phys. 2011;80:47–54.

    Article  PubMed  Google Scholar 

  88. Yasar B, Yasar S, Gunes P. Extramammary Paget’s disease of the perianal region treated successfully with radiotherapy. Int J Color Dis. 2015;30:711–2.

    Article  Google Scholar 

  89. Runfola MA, Weber TK, Rodriguez-Bigas MA, et al. Photodynamic therapy for residual neoplasms of the perianal skin. Dis Colon Rectum. 2000;43:499–502.

    Article  CAS  PubMed  Google Scholar 

  90. Bowen JT. Precancerous dermatoses: a study of 2 cases of chronic atypical epithelial proliferation. J Cutan Dis. 1912;30:241–55.

    Google Scholar 

  91. Vickers PM, Jackman RJ, McDonald JR. Anal carcinoma in situ: report of three cases. South Surg. 1939;8:503–7.

    Google Scholar 

  92. Cleary RK, Schaldenbrand JD, Fowler JJ, et al. Perianal Bowen’s disease and anal intraepithelial neoplasia: review of the literature. Dis Colon Rectum. 1999;42:945–51.

    Article  CAS  PubMed  Google Scholar 

  93. Margenthaler JA, Dietz DW, Mutch MG, et al. Outcomes, risk of other malignancies, and need for formal mapping procedures in patients with perianal Bowen’s disease. Dis Colon Rectum. 2004;47:1655–60. discussion 1660-1

    Article  PubMed  Google Scholar 

  94. Beck DE, Fazio VW, Jagelman DG, Lavery IC. Perianal Bowen’s disease. Dis Colon Rectum. 1988;31:419–22.

    Article  CAS  PubMed  Google Scholar 

  95. Marchesa P, Fazio VW, Oliart S, et al. Perianal Bowen’s disease: a clinicopathologic study of 47 patients. Dis Colon Rectum. 1997;40:1286–93.

    Article  CAS  PubMed  Google Scholar 

  96. Sarmiento JM, Wolff BG, Burgart LJ, et al. Perianal Bowen’s disease: associated tumors, human papillomavirus, surgery, and other controversies. Dis Colon Rectum. 1997;40:912–8.

    Article  CAS  PubMed  Google Scholar 

  97. Graham BD, Jetmore AB, Foote JE, Arnold LK. Topical 5-fluorouracil in the management of extensive anal Bowen’s disease: a preferred approach. Dis Colon Rectum. 2005;48:444–50.

    Article  PubMed  Google Scholar 

  98. Welch ML, Grabski WJ, McCollough ML, et al. 5-fluorouracil iontophoretic therapy for Bowen’s disease. J Am Acad Dermatol. 1997;36(6 Pt 1):956–8.

    Article  CAS  PubMed  Google Scholar 

  99. Newlin HE, Zlotecki RA, Morris CG, et al. Squamous cell carcinoma of the anal margin. J Surg Oncol. 2004;86:55–62.

    Article  PubMed  Google Scholar 

  100. Nielsen OV, Jensen SL. Basal cell carcinoma of the anus – a clinical study of 34 cases. Br J Surg. 1981;68:856–7.

    Article  CAS  PubMed  Google Scholar 

  101. Paterson CA, Young-Fadok TM, Dozois RR. Basal cell carcinoma of the perianal region: 20-year experience. Dis Colon Rectum. 1999;42:1200–2.

    Article  CAS  PubMed  Google Scholar 

  102. Gibson GE, Ahmed I. Perianal and genital basal cell carcinoma: a clinicopathologic review of 51 cases. J Am Acad Dermatol. 2001;45:68–71.

    Article  CAS  PubMed  Google Scholar 

  103. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap7.pdf. Accessed 1 April 2017.

  104. Edge SB, Byrd DB, Compton CC, et al. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.

    Google Scholar 

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Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Ochsner Medical Center, New Orleans, LA, USA

    Brian R. Kann

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Editors and Affiliations

  1. Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA

    David E. Beck

  2. Department of Colon and Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Scott R. Steele

  3. Department of Colon and Rectal Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner

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Kann, B.R. (2019). Anal Neoplasms. In: Beck, D., Steele, S., Wexner, S. (eds) Fundamentals of Anorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65966-4_19

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