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Abstract

This chapter, reviews the anatomy that defines anal and perianal squamous cell carcinomas (SCCs), discusses the cancers and precursor lesions that are most frequently found in these regions, and concludes with brief discussions of the less common malignancies of the anus and perineum.

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References

  1. Welton ML, Sharkey FE, Kahlenberg MS. The etiology and epidemiology of anal cancer. Surg Oncol Clin North Am 2004; 13:263–275.

    Google Scholar 

  2. Frisch M, Glimelius B, Brule AJ, van den et al. Sexually transmitted infection as a cause of anal cancer. N Engl J Med 1997;337:1350–1358.

    CAS  PubMed  Google Scholar 

  3. Munoz N, Bosch FX, de Sanjose S, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003;348:518–527.

    PubMed  Google Scholar 

  4. Strickler HD, Schiffman MH. Is human papillomavirus an infectious cause of non‐cervical anogenital tract cancers? BMJ 1997;315:620–621.

    CAS  PubMed  Google Scholar 

  5. Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 1997;102:3–8.

    CAS  PubMed  Google Scholar 

  6. O'Mahony C, Law C, Gollnick HP, Marini M. New patient‐applied therapy for anogenital warts is rated favourably by patients. Int J STD AIDS 2001;12:565–570.

    PubMed  Google Scholar 

  7. Bauer HM, Ting Y, Greer CE, et al. Genital human papillomavirus infection in female university students as determined by a PCR‐based method. JAMA 1991;265:472–477.

    CAS  PubMed  Google Scholar 

  8. Pecoraro G, Morgan D, Defendi V. Differential effects of human papillomavirus type 6, 16, and 18 DNAs on immortalization and transformation of human cervical epithelial cells. Proc Natl Acad Sci USA 1989;86:563–567.

    CAS  PubMed  Google Scholar 

  9. Woodworth CD, Doniger J, Di Paolo JA. Immortalization of human foreskin keratinocytes by various human papillomavirus DNAs corresponds to their association with cervical carcinoma. J Virol 1989;63:159–164.

    CAS  PubMed  Google Scholar 

  10. Snoek EM, van der Niesters HG, Mulder PG, van Doornum GJ, Osterhaus AD, Meijden WI. van der Human papillomavirus infection in men who have sex with men participating in a Dutch gay‐cohort study. Sex Transm Dis 2003;30: 639–644.

    PubMed  Google Scholar 

  11. Palefsky JM, Gonzales J, Greenblatt RM, Ahn DK, Hollander H. Anal intraepithelial neoplasia and anal papillomavirus infection among homosexual males with group IV HIV disease. JAMA 1990;263:2911–2916.

    CAS  PubMed  Google Scholar 

  12. Palefsky JM, Holly EA, Gonzales J, Berline J, Ahn DK, Greenspan JS. Detection of human papillomavirus DNA in anal intraepithelial neoplasia and anal cancer. Cancer Res 1991;51:1014–1019.

    CAS  PubMed  Google Scholar 

  13. Jay N, Berry JM, Hogeboom CJ, Holly EA, Darragh TM, Palefsky JM. Colposcopic appearance of anal squamous intraepithelial lesions: relationship to histopathology. Dis Colon Rectum 1997;40:919–928.

    CAS  PubMed  Google Scholar 

  14. Holly EA, Whittemore AS, Aston DA, Ahn DK, Nickoloff BJ, Kristiansen JJ. Anal cancer incidence: genital warts, anal fissure or fistula, hemorrhoids, and smoking. J Natl Cancer Inst 1989;81:1726–1731.

    CAS  PubMed  Google Scholar 

  15. Bosch FX, Lorincz A, Munoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002;55:244–265.

    CAS  PubMed  Google Scholar 

  16. Hildesheim A, Schiffman MH, Tsukui T, et al. Immune activation in cervical neoplasia: cross‐sectional association between plasma soluble interleukin 2 receptor levels and disease. Cancer Epidemiol Biomarkers Prev 1997;6:807–813.

    CAS  PubMed  Google Scholar 

  17. Palefsky JM, Holly EA, Ralston ML, Da Costa M, Greenblatt RM. Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)‐positive and high‐risk HIV‐negative women. J Infect Dis 2001;183:383–391.

    CAS  PubMed  Google Scholar 

  18. Holly EA, Ralston ML, Darragh TM, Greenblatt RM, Jay N, Palefsky JM. Prevalence and risk factors for anal squamous intraepithelial lesions in women. J Natl Cancer Inst 2001;93: 843–849.

    CAS  PubMed  Google Scholar 

  19. Sobhani I, Vuagnat A, Walker F, et al. Prevalence of high‐grade dysplasia and cancer in the anal canal in human papillomavirus‐infected individuals. Gastroenterology 2001;120:857–866.

    CAS  PubMed  Google Scholar 

  20. Cress RD, Holly EA. Incidence of anal cancer in California: increased incidence among men in San Francisco, 1973–1999. Prev Med 2003;36:555–560.

    PubMed  Google Scholar 

  21. Penn I. Cancers of the anogenital region in renal transplant recipients. Analysis of 65 cases. Cancer 1986;58:611–616.

    CAS  PubMed  Google Scholar 

  22. Penn I. Cancer in the immunosuppressed organ recipient. Transplant Proc 1991;23:1771–1772.

    CAS  PubMed  Google Scholar 

  23. McGlennen RC. Human papillomavirus oncogenesis. Clin Lab Med 2000;20:383–406.

    CAS  PubMed  Google Scholar 

  24. zur Hausen H. Immortalization of human cells and their malignant conversion by high risk human papillomavirus genotypes. Semin Cancer Biol 1999;9:405–411.

    CAS  PubMed  Google Scholar 

  25. Martin F, Bower M. Anal intraepithelial neoplasia in HIV positive people. Sex Transm Infect 2001;77:327–331.

    CAS  PubMed  Google Scholar 

  26. Werness BA, Levine AJ, Howley PM. Association of human papillomavirus types 16 and 18 E6 proteins with p53. Science 1990;248:76–79.

    CAS  PubMed  Google Scholar 

  27. Chow LT, Broker TR. Papillomavirus DNA replication. Intervirology 1994;37:150–158.

    CAS  PubMed  Google Scholar 

  28. Dollard SC, Wilson JL, Demeter LM, et al. Production of human papillomavirus and modulation of the infectious program in epithelial raft cultures. OFF. Genes Dev 1992;6: 1131–1142.

    CAS  Google Scholar 

  29. Flores ER, Lambert PF. Evidence for a switch in the mode of human papillomavirus type 16 DNA replication during the viral life cycle. J Virol 1997;71:7167–7179.

    CAS  PubMed  Google Scholar 

  30. Litle VR, Leavenworth JD, Darragh TM, et al. Angiogenesis, proliferation, and apoptosis in anal high‐grade squamous intraepithelial lesions. Dis Colon Rectum 2000;43:346–352.

    CAS  PubMed  Google Scholar 

  31. Chang GJ, Berry JM, Jay N, Palefsky JM, Welton ML. Surgical treatment of high‐grade anal squamous intraepithelial lesions: a prospective study. Dis Colon Rectum 2002;45:453–458.

    PubMed  Google Scholar 

  32. Goldie SJ, Kuntz KM, Weinstein MC, Freedberg KA, Welton ML, Palefsky JM. The clinical effectiveness and cost‐effectiveness of screening for anal squamous intraepithelial lesions in homosexual and bisexual HIV‐positive men. JAMA 1999; 281:1822–1829.

    CAS  PubMed  Google Scholar 

  33. Goldie SJ, Kuntz KM, Weinstein MC, Freedberg KA, Palefsky JM. Cost‐effectiveness of screening for anal squamous intraepithelial lesions and anal cancer in human immunodeficiency virus‐negative homosexual and bisexual men. Am J Med 2000;108:634–641.

    CAS  PubMed  Google Scholar 

  34. Daling JR, Weiss NS, Hislop TG, et al. Sexual practices, sexually transmitted diseases, and the incidence of anal cancer. N Engl J Med 1987;317:973–977.

    CAS  PubMed  Google Scholar 

  35. Scholefield JH, Sonnex C, Talbot IC, et al. Anal and cervical intraepithelial neoplasia: possible parallel. Lancet 1989;2: 765–769.

    CAS  PubMed  Google Scholar 

  36. Rabkin CS, Yellin F. Cancer incidence in a population with a high prevalence of infection with human immunodeficiency virus type 1. J Natl Cancer Inst 1994;86:1711–1716.

    CAS  PubMed  Google Scholar 

  37. Koblin BA, Hessol NA, Zauber AG, et al. Increased incidence of cancer among homosexual men, New York City and San Francisco, 1978–1990. Am J Epidemiol 1996;144:916–923.

    CAS  PubMed  Google Scholar 

  38. Critchlow CW, Surawicz CM, Holmes KK, et al. Prospective study of high grade anal squamous intraepithelial neoplasia in a cohort of homosexual men: influence of HIV infection, immunosuppression and human papillomavirus infection. AIDS 1995;9:1255–1262.

    CAS  PubMed  Google Scholar 

  39. Palefsky JM, Holly EA, Ralston ML, et al. Anal squamous intraepithelial lesions in HIV‐positive and HIV‐negative homosexual and bisexual men: prevalence and risk factors. J Acquir Immune Defic Syndr Hum Retrovirol 1998;17:320–326.

    CAS  PubMed  Google Scholar 

  40. Palefsky JM, Holly EA, Hogeboom CJ, et al. Virologic, immunologic, and clinical parameters in the incidence and progression of anal squamous intraepithelial lesions in HIV‐positive and HIV‐negative homosexual men. J Acquir Immune Defic Syndr Hum Retrovirol 1998;17:314–319.

    CAS  PubMed  Google Scholar 

  41. 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;92:1500–1510.

    CAS  PubMed  Google Scholar 

  42. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin 2000;50:7–33.

    CAS  PubMed  Google Scholar 

  43. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin 2003;53:5–26.

    PubMed  Google Scholar 

  44. Goldman S, Glimelius B, Nilsson B, Pahlman L. Incidence of anal epidermoid carcinoma in Sweden 1970–1984. Acta Chir Scand 1989;155:191–197.

    CAS  PubMed  Google Scholar 

  45. Frisch M, Melbye M, Moller H. Trends in incidence of anal cancer in Denmark. BMJ 1993;306:419–422.

    CAS  PubMed  Google Scholar 

  46. Melbye M, Sprogel P. Aetiological parallel between anal cancer and cervical cancer. Lancet 1991;338:657–659.

    CAS  PubMed  Google Scholar 

  47. Holmes F, Borek D, Owen‐Kummer M, et al. Anal cancer in women. Gastroenterology 1988;95:107–111.

    CAS  PubMed  Google Scholar 

  48. Palefsky JM, Shiboski S, Moss A. Risk factors for anal human papillomavirus infection and anal cytologic abnormalities in HIV‐positive and HIV‐negative homosexual men. J Acquir Immune Defic Syndr 1994;7:599–606.

    CAS  PubMed  Google Scholar 

  49. Caussy D, Goedert JJ, Palefsky J, et al. Interaction of human immunodeficiency and papilloma viruses: association with anal epithelial abnormality in homosexual men. Int J Cancer 1990;46:214–219.

    CAS  PubMed  Google Scholar 

  50. Friedman HB, Saah AJ, Sherman ME, et al. Human papillomavirus, anal squamous intraepithelial lesions, and human immunodeficiency virus in a cohort of gay men. J Infect Dis 1998;178:45–52.

    CAS  PubMed  Google Scholar 

  51. Palefsky JM, Holly EA, Ralston ML, Jay N, Berry JM, Darragh TM. High incidence of anal high‐grade squamous intra‐epithelial lesions among HIV‐positive and HIV‐negative homosexual and bisexual men. AIDS 1998;12:495–503.

    CAS  PubMed  Google Scholar 

  52. Ogunbiyi OA, Scholefield JH, Raftery AT, et al. Prevalence of anal human papillomavirus infection and intraepithelial neoplasia in renal allograft recipients. Br J Surg 1994;81:365–367.

    CAS  PubMed  Google Scholar 

  53. Daling JR, Sherman KJ, Hislop TG, et al. Cigarette smoking and the risk of anogenital cancer. Am J Epidemiol 1992;135: 180–189.

    CAS  PubMed  Google Scholar 

  54. Marfing TE, Abel ME, Gallagher DM. Perianal Bowen's disease and associated malignancies. Results of a survey. Dis Colon Rectum 1987;30:782–785.

    CAS  PubMed  Google Scholar 

  55. Arbesman H, Ransohoff DF. Is Bowen's disease a predictor for the development of internal malignancy? A methodological critique of the literature. JAMA 1987;257:516–518.

    CAS  PubMed  Google Scholar 

  56. Marchesa P, Fazio VW, Oliart S, Goldblum JR, Lavery IC. Perianal Bowen's disease: a clinicopathologic study of 47 patients. Dis Colon Rectum 1997;40:1286–1293.

    CAS  PubMed  Google Scholar 

  57. Brown SR, Skinner P, Tidy J, Smith JH, Sharp F, Hosie KB. Outcome after surgical resection for high‐grade anal intraepithelial neoplasia (Bowen's disease). Br J Surg 1999;86: 1063–1066.

    CAS  PubMed  Google Scholar 

  58. Bargman H, Hochman J. Topical treatment of Bowen's disease with 5‐fluorouracil. J Cutan Med Surg 2003;7:101–105.

    PubMed  Google Scholar 

  59. Wang KH, Fang JY, Hu CH, Lee WR. Erbium:YAG laser pretreatment accelerates the response of Bowen's disease treated by topical 5‐fluorouracil. Dermatol Surg 2004;30:441–445.

    PubMed  Google Scholar 

  60. Snoeck R, Van Laethem Y, De Clercq E, De Maubeuge J, Clumeck N. Treatment of a bowenoid papulosis of the penis with local applications of cidofovir in a patient with acquired immunodeficiency syndrome. Arch Intern Med 2001;161: 2382–2384.

    CAS  PubMed  Google Scholar 

  61. Okamoto A, Woodworth CD, Yen K, et al. Combination therapy with podophyllin and vidarabine for human papillomavirus positive cervical intraepithelial neoplasia. Oncol Rep 1999;6: 269–276.

    CAS  PubMed  Google Scholar 

  62. Micali G, Nasca MR, Tedeschi A. Topical treatment of intraepithelial penile carcinoma with imiquimod. Clin Exp Dermatol 2003;28(suppl 1):4–6.

    PubMed  Google Scholar 

  63. Smith KJ, Germain M, Skelton H. Squamous cell carcinoma in situ (Bowen's disease) in renal transplant patients treated with 5% imiquimod and 5% 5‐fluorouracil therapy. Dermatol Surg 2001;27:561–564.

    CAS  PubMed  Google Scholar 

  64. Pehoushek J, Smith KJ. Imiquimod and 5% fluorouracil therapy for anal and perianal squamous cell carcinoma in situ in an HIV‐1‐positive man. Arch Dermatol 2001;137:14–16.

    CAS  PubMed  Google Scholar 

  65. Panizzon RG. Radiotherapy of skin tumors. Recent Results Cancer Res 2002;160:234–239.

    CAS  PubMed  Google Scholar 

  66. Chung YL, Lee JD, Bang D, Lee JB, Park KB, Lee MG. Treatment of Bowen's disease with a specially designed radioactive skin patch. Eur J Nucl Med 2000;27:842–846.

    CAS  PubMed  Google Scholar 

  67. Webber J, Fromm D. Photodynamic therapy for carcinoma in situ of the anus. Arch Surg 2004;139:259–261.

    CAS  PubMed  Google Scholar 

  68. Varma S, Wilson H, Kurwa HA, et al. Bowen's disease, solar keratoses and superficial basal cell carcinomas treated by photodynamic therapy using a large‐field incoherent light source. Br J Dermatol 2001;144:567–574.

    CAS  PubMed  Google Scholar 

  69. Salim A, Leman JA, McColl JH, Chapman R, Morton CA. Randomized comparison of photodynamic therapy with topical 5‐fluorouracil in Bowen's disease. Br J Dermatol 2003;148: 539–543.

    CAS  PubMed  Google Scholar 

  70. Behrendt GC, Hansmann ML. Carcinomas of the anal canal and anal margin differ in their expression of cadherin, cytokeratins and p53. Virchows Arch 2001;439:782–786.

    CAS  PubMed  Google Scholar 

  71. Anal Canal. AJCC Cancer Staging Manual, 6th ed. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (eds). New York: Springer; 2002:125–130.

    Google Scholar 

  72. Gervasoni JE Jr, Wanebo HJ. Cancers of the anal canal and anal margin. Cancer Invest 2003;21:452–464.

    PubMed  Google Scholar 

  73. Skibber J, Rodriguez‐Bigas MA, Gordon PH. Surgical considerations in anal cancer. Surg Oncol Clin North Am 2004;13: 321–338.

    Google Scholar 

  74. Newlin HE, Zlotecki RA, Morris CG, Hochwald SN, Riggs CE, Mendenhall WM. Squamous cell carcinoma of the anal margin. J Surg Oncol 2004;86:55–62; discussion 63.

    PubMed  Google Scholar 

  75. Jensen SL, Hagen K, Shokouh‐Amiri MH, Nielsen OV. Does an erroneous diagnosis of squamous‐cell carcinoma of the anal canal and anal margin at first physician visit influence prognosis? Dis Colon Rectum 1987;30:345–351.

    CAS  PubMed  Google Scholar 

  76. Winburn GB. Anal carcinoma or “just hemorrhoids”? Am Surg 2001;67:1048–1058.

    CAS  PubMed  Google Scholar 

  77. Mendenhall WM, Zlotecki RA, Vauthey JN, Copeland EM 3rd. Squamous cell carcinoma of the anal margin treated with radiotherapy. Surg Oncol 1996;5:29–35.

    CAS  PubMed  Google Scholar 

  78. Papillon J, Chassard JL. Respective roles of radiotherapy and surgery in the management of epidermoid carcinoma of the anal margin. Series of 57 patients. Dis Colon Rectum 1992;35: 422–429.

    CAS  PubMed  Google Scholar 

  79. Nivatvongs S. Perianal and anal canal neoplasms. In: Gordon PH, Nivatvongs S, eds. Principles and Practice of Surgery for the Colon, Rectum, and Anus. St. Louis: Quality Medical Publishing; 1999:448–471.

    Google Scholar 

  80. Jensen SL, Hagen K, Harling H, Shokouh‐Amiri MH, Nielsen OV. Long‐term prognosis after radical treatment for squamous‐cell carcinoma of the anal canal and anal margin. Dis Colon Rectum 1988;31:273–278.

    CAS  PubMed  Google Scholar 

  81. Greenall MJ, Quan SH, Stearns MW, Urmacher C, De Cosse JJ. Epidermoid cancer of the anal margin. Pathologic features, treatment, and clinical results. Am J Surg 1985;149:95–101.

    CAS  PubMed  Google Scholar 

  82. Al‐Jurf AS, Turnbull RP, Fazio VW. Local treatment of squamous cell carcinoma of the anus. Surg Gynecol Obstet 1979;148:576–578.

    PubMed  Google Scholar 

  83. Schraut WH, Wang CH, Dawson PJ, Block GE. Depth of invasion, location, and size of cancer of the anus dictate operative treatment. Cancer 1983;51:1291–1296.

    CAS  PubMed  Google Scholar 

  84. Pintor MP, Northover JM, Nicholls RJ. Squamous cell carcinoma of the anus at one hospital from 1948 to 1984. Br J Surg 1989;76:806–810.

    CAS  PubMed  Google Scholar 

  85. Beahrs OH, Wilson SM. Carcinoma of the anus. Ann Surg 1976;184:422–428.

    CAS  PubMed  Google Scholar 

  86. Peiffert D, Bey P, Pernot M, et al. Conservative treatment by irradiation of epidermoid carcinomas of the anal margin. Int J Radiat Oncol Biol Phys 1997;39:57–66.

    CAS  PubMed  Google Scholar 

  87. Touboul E, Schlienger M, Buffat L, et al. Epidermoid carcinoma of the anal margin: 17 cases treated with curative‐intent radiation therapy. Radiother Oncol 1995;34:195–202.

    CAS  PubMed  Google Scholar 

  88. Mendenhall WM, Zlotecki RA, Vauthey JN, Copeland EM 3rd. Squamous cell carcinoma of the anal margin. Oncology (Williston Park) 1996;10:1843–1848; discussion 1848, 1853–1854.

    CAS  Google Scholar 

  89. Cummings BJ, Keane TJ, Hawkins NV, O'Sullivan B. Treatment of perianal carcinoma by radiation(RT) or radiation plus chemotherapy(RTCT). Int J Radiat Oncol Biol Phys 1986;12:170.

    Google Scholar 

  90. Cutuli B, Fenton J, Labib A, Bataini JP, Mathieu G. Anal margin carcinoma: 21 cases treated at the Institut Curie by exclusive conservative radiotherapy. Radiother Oncol 1988;11:1–6.

    CAS  PubMed  Google Scholar 

  91. John MJ, Flam M, Lovalvo L, Mowry PA. Feasibility of non‐surgical definitive management of anal canal carcinoma. Int J Radiat Oncol Biol Phys 1987;13:299–303.

    CAS  PubMed  Google Scholar 

  92. 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;15:2040–2049.

    CAS  PubMed  Google Scholar 

  93. UKCCCR. Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5‐fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co‐ordinating Committee on Cancer Research. Lancet 1996;348:1049–1054.

    Google Scholar 

  94. Roelofsen F, Bartelink H. Combined modality treatment of anal carcinoma. Oncologist 1998;3:413–418.

    PubMed  Google Scholar 

  95. Allal AS, Mermillod B, Roth AD, Marti MC, Kurtz JM. Impact of clinical and therapeutic factors on major late complications after radiotherapy with or without concomitant chemotherapy for anal carcinoma. Int J Radiat Oncol Biol Phys 1997;39: 1099–1105.

    CAS  PubMed  Google Scholar 

  96. Bieri S, Allal AS, Kurtz JM. Sphincter‐conserving treatment of carcinomas of the anal margin. Acta Oncol 2001;40:29–33.

    CAS  PubMed  Google Scholar 

  97. Dougherty BG, Evans HL. Carcinoma of the anal canal: a study of 79 cases. Am J Clin Pathol 1985;83:159–164.

    CAS  PubMed  Google Scholar 

  98. Rousseau DL Jr, Petrelli NJ, Kahlenberg MS. Overview of anal cancer for the surgeon. Surg Oncol Clin North Am 2004;13: 249–262.

    Google Scholar 

  99. Clark MA, Hartley A, Geh JI. Cancer of the anal canal. Lancet Oncol 2004;5:149–157.

    PubMed  Google Scholar 

  100. Boman BM, Moertel CG, O'Connell MJ, et al. Carcinoma of the anal canal. A clinical and pathologic study of 188 cases. Cancer 1984;54:114–125.

    CAS  PubMed  Google Scholar 

  101. Roseau G, Palazzo L, Colardelle P, Chaussade S, Couturier D, Paolaggi JA. Endoscopic ultrasonography in the staging and follow‐up of epidermoid carcinoma of the anal canal. Gastrointest Endosc 1994;40:447–450.

    CAS  PubMed  Google Scholar 

  102. Drudi FM, Raffetto N, De Rubeis M, et al. TRUS staging and follow‐up in patients with anal canal cancer. Radiol Med (Torino) 2003;106:329–337.

    Google Scholar 

  103. Giovannini M, Bardou VJ, Barclay R, et al. Anal carcinoma: prognostic value of endorectal ultrasound (ERUS). Results of a prospective multicenter study. Endoscopy 2001;33:231–236.

    CAS  PubMed  Google Scholar 

  104. Goldman S, Glimelius B, Norming U, Pahlman L, Seligson U. Transanorectal ultrasonography in anal carcinoma. A prospective study of 21 patients. Acta Radiol 1988;29:337–341.

    CAS  PubMed  Google Scholar 

  105. Christensen AF, Nielsen MB, Engelholm SA, Roed H, Svendsen LB, Christensen H. Three‐dimensional anal endosonography may improve staging of anal cancer compared with two‐dimensional endosonography. Dis Colon Rectum 2004;47:341–345.

    PubMed  Google Scholar 

  106. Fuchshuber PR, Rodriguez‐Bigas M, Weber T, Petrelli NJ. Anal canal and perianal epidermoid cancers. J Am Coll Surg 1997;185:494–505.

    CAS  PubMed  Google Scholar 

  107. Perera D, Pathma‐Nathan N, Rabbitt P, Hewett P, Rieger N. Sentinel node biopsy for squamous‐cell carcinoma of the anus and anal margin. Dis Colon Rectum 2003;46:1027–1029; discussion 1030–1031.

    CAS  PubMed  Google Scholar 

  108. Hoffman R, Welton ML, Klencke B, Weinberg V, Krieg R. The significance of pretreatment CD4 count on the outcome and treatment tolerance of HIV‐positive patients with anal cancer. Int J Radiat Oncol Biol Phys 1999;44:127–131.

    CAS  PubMed  Google Scholar 

  109. Eng C, Abbruzzese J, Minsky BD. Chemotherapy and radiation of anal canal cancer: the first approach. Surg Oncol Clin North Am 2004;13:309–320, viii.

    Google Scholar 

  110. Deniaud‐Alexandre E, Touboul E, Tiret E, et al. Results of definitive irradiation in a series of 305 epidermoid carcinomas of the anal canal. Int J Radiat Oncol Biol Phys 2003;56: 1259–1273.

    PubMed  Google Scholar 

  111. Touboul E, Schlienger M, Buffat L, et al. Epidermoid carcinoma of the anal canal. Results of curative‐intent radiation therapy in a series of 270 patients. Cancer 1994;73:1569–1579.

    CAS  PubMed  Google Scholar 

  112. Gerard JP, Chapet O, Samiei F, et al. Management of inguinal lymph node metastases in patients with carcinoma of the anal canal: experience in a series of 270 patients treated in Lyon and review of the literature. Cancer 2001;92:77–84.

    CAS  PubMed  Google Scholar 

  113. Cummings BJ. Treatment of primary epidermoid carcinoma of the anal canal. Int J Colorectal Dis 1987;2:107–112.

    CAS  PubMed  Google Scholar 

  114. Wade DS, Herrera L, Castillo NB, Petrelli NJ. Metastases to the lymph nodes in epidermoid carcinoma of the anal canal studied by a clearing technique. Surg Gynecol Obstet 1989;169:238–242.

    CAS  PubMed  Google Scholar 

  115. Ryan DP, Mayer RJ. Anal carcinoma: histology, staging, epidemiology, treatment. Curr Opin Oncol 2000;12:345–352.

    CAS  PubMed  Google Scholar 

  116. Hughes LL, Rich TA, Delclos L, Ajani JA, Martin RG. Radiotherapy for anal cancer: experience from 1979–1987. Int J Radiat Oncol Biol Phys 1989;17:1153–1160.

    CAS  PubMed  Google Scholar 

  117. Constantinou EC, Daly W, Fung CY, Willett CG, Kaufman DS, De Laney TF. Time‐dose considerations in the treatment of anal cancer. Int J Radiat Oncol Biol Phys 1997;39:651–657.

    CAS  PubMed  Google Scholar 

  118. John M, Pajak T, Flam M, et al. Dose escalation in chemoradiation for anal cancer: preliminary results of RTOG 92‐08. Cancer J Sci Am 1996;2:205.

    CAS  PubMed  Google Scholar 

  119. Myerson RJ, Kong F, Birnbaum EH, et al. Radiation therapy for epidermoid carcinoma of the anal canal, clinical and treatment factors associated with outcome. Radiother Oncol 2001;61:15–22.

    CAS  PubMed  Google Scholar 

  120. Cummings BJ, Keane TJ, O'Sullivan B, Wong CS, Catton CN. Epidermoid anal cancer: treatment by radiation alone or by radiation and 5‐fluorouracil with and without mitomycin C. Int J Radiat Oncol Biol Phys 1991;21:1115–1125.

    CAS  PubMed  Google Scholar 

  121. Nguyen WD, Mitchell KM, Beck DE. Risk factors associated with requiring a stoma for the management of anal cancer. Dis Colon Rectum 2004;47:843–846.

    PubMed  Google Scholar 

  122. Ng Ying Kin NY, Pigneux J, Auvray H, Brunet R, Thomas L, Denepoux R. Our experience of conservative treatment of anal canal carcinoma combining external irradiation and interstitial implant: 32 cases treated between 1973 and 1982. Int J Radiat Oncol Biol Phys 1988;14:253–259.

    CAS  PubMed  Google Scholar 

  123. Papillon J, Montbarbon JF. Epidermoid carcinoma of the anal canal. A series of 276 cases. Dis Colon Rectum 1987;30: 324–333.

    CAS  PubMed  Google Scholar 

  124. Mitchell SE, Mendenhall WM, Zlotecki RA, Carroll RR. Squamous cell carcinoma of the anal canal. Int J Radiat Oncol Biol Phys 2001;49:1007–1013.

    CAS  PubMed  Google Scholar 

  125. Nigro ND, Vaitkevicius VK, Considine B Jr. Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 1974;17:354–356.

    CAS  PubMed  Google Scholar 

  126. Buroker TR, Nigro N, Bradley G, et al. Combined therapy for cancer of the anal canal: a follow‐up report. Dis Colon Rectum 1977;20:677–678.

    CAS  PubMed  Google Scholar 

  127. Nigro ND. An evaluation of combined therapy for squamous cell cancer of the anal canal. Dis Colon Rectum 1984;27:763–766.

    CAS  PubMed  Google Scholar 

  128. Flam M, John M, PajakTF, 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;14:2527–2539.

    CAS  PubMed  Google Scholar 

  129. Hung A, Crane C, DelclosM, et al. Cisplatin‐based combined modality therapy for anal carcinoma: a wider therapeutic index. Cancer 2003;97:1195–1202.

    CAS  PubMed  Google Scholar 

  130. Gerard JP, Ayzac L, HunD, et al. Treatment of anal canal carcinoma with high dose radiation therapy and concomitant fluorouracil‐cisplatinum. Long‐term results in 95 patients. Radiother Oncol 1998;46:249–256.

    CAS  PubMed  Google Scholar 

  131. Lund JA, Sundstrom SH, Haaverstad R, Wibe A, Svinsaas M, Myrvold HE. Endoanal ultrasound is of little value in follow‐up of anal carcinomas. Dis Colon Rectum 2004;47:839–842.

    PubMed  Google Scholar 

  132. Wal BC, van der Cleffken BI, Gulec B, Kaufman HS, Choti MA. Results of salvage abdominoperineal resection for recurrent anal carcinoma following combined chemoradiation therapy. J Gastrointest Surg 2001;5:383–387.

    PubMed  Google Scholar 

  133. Zelnick RS, Haas PA, Ajlouni M, Szilagyi E, Fox TA Jr. Results of abdominoperineal resections for failures after combination chemotherapy and radiation therapy for anal canal cancers. Dis Colon Rectum 1992;35:574–577; discussion 577–578.

    CAS  PubMed  Google Scholar 

  134. Pocard M, Tiret E, Nugent K, Dehni N, Parc R. Results of salvage abdominoperineal resection for anal cancer after radiotherapy. Dis Colon Rectum 1998;41:1488–1493.

    CAS  PubMed  Google Scholar 

  135. Ellenhorn JD, Enker WE, Quan SH. Salvage abdominoperineal resection following combined chemotherapy and radiotherapy for epidermoid carcinoma of the anus. Ann Surg Oncol 1994;1: 105–110.

    CAS  PubMed  Google Scholar 

  136. Allal AS, Laurencet FM, Reymond MA, Kurtz JM, Marti MC. Effectiveness of surgical salvage therapy for patients with locally uncontrolled anal carcinoma after sphincter‐conserving treatment. Cancer 1999;86:405–409.

    CAS  PubMed  Google Scholar 

  137. Akbari RP, Paty PB, Guillem JG, et al. Oncologic outcomes of salvage surgery for epidermoid carcinoma of the anus initially managed with combined modality therapy. Dis Colon Rectum 2004;47:1136–1144.

    PubMed  Google Scholar 

  138. Nilsson PJ, Svensson C, Goldman S, Glimelius B. Salvage abdominoperineal resection in anal epidermoid cancer. Br J Surg 2002;89:1425–1429.

    CAS  PubMed  Google Scholar 

  139. Greenall MJ, Magill GB, Quan SH, De Cosse JJ. Recurrent epidermoid cancer of the anus. Cancer 1986;57:1437–1441.

    CAS  PubMed  Google Scholar 

  140. Klas JV, Rothenberger DA, Wong WD, Madoff RD. Malignant tumors of the anal canal: the spectrum of disease, treatment, and outcomes. Cancer 1999;85:1686–1693.

    CAS  PubMed  Google Scholar 

  141. Beal KP, Wong D, Guillem JG, et al. Primary adenocarcinoma of the anus treated with combined modality therapy. Dis Colon Rectum 2003;46:1320–1324.

    PubMed  Google Scholar 

  142. Basik M, Rodriguez‐Bigas MA, Penetrante R, Petrelli NJ. Prognosis and recurrence patterns of anal adenocarcinoma. Am J Surg 1995;169:233–237.

    CAS  PubMed  Google Scholar 

  143. Papagikos M, Crane CH, Skibber J, et al. Chemoradiation for adenocarcinoma of the anus. Int J Radiat Oncol Biol Phys 2003;55:669–678.

    PubMed  Google Scholar 

  144. Belkacemi Y, Berger C, Poortmans P, et al. Management of primary anal canal adenocarcinoma: a large retrospective study from the Rare Cancer Network. Int J Radiat Oncol Biol Phys 2003;56:1274–1283.

    PubMed  Google Scholar 

  145. Malik A, Hull TL, Floruta C. What is the best surgical treatment for anorectal melanoma? Int J Colorectal Dis 2004;19: 121–123.

    PubMed  Google Scholar 

  146. Billingsley KG, Stern LE, Lowy AM, Kahlenberg MS, Thomas CR Jr. Uncommon anal neoplasms. Surg Oncol Clin North Am 2004;13:375–388.

    Google Scholar 

  147. Chang AE, Karnell 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;83:1664–1678.

    CAS  PubMed  Google Scholar 

  148. Brady MS, Kavolius JP, Quan SH. Anorectal melanoma. A 64‐year experience at Memorial Sloan‐Kettering Cancer Center. Dis Colon Rectum 1995;38:146–151.

    CAS  PubMed  Google Scholar 

  149. Thibault C, Sagar P, Nivatvongs S, Ilstrup DM, Wolff BG. Anorectal melanoma: an incurable disease? Dis Colon Rectum 1997;40:661–668.

    CAS  PubMed  Google Scholar 

  150. Weyandt GH, Eggert AO, Houf M, Raulf F, Brocker EB, Becker JC. Anorectal melanoma: surgical management guidelines according to tumour thickness. Br J Cancer 2003;89: 2019–2022.

    CAS  PubMed  Google Scholar 

  151. Bullard KM, Tuttle TM, Rothenberger DA, et al. Surgical therapy for anorectal melanoma. J Am Coll Surg 2003;196:206–211.

    PubMed  Google Scholar 

  152. Moozar KL, Wong CS, Couture J. Anorectal malignant melanoma: treatment with surgery or radiation therapy, or both. Can J Surg 2003;46:345–349.

    PubMed  Google Scholar 

  153. Roumen RM. Anorectal melanoma in The Netherlands: a report of 63 patients. Eur J Surg Oncol 1996;22:598–601.

    CAS  PubMed  Google Scholar 

  154. Eton O, Legha SS, Bedikian AY, et al. Sequential biochemotherapy versus chemotherapy for metastatic melanoma: results from a phase III randomized trial. J Clin Oncol 2002; 20:2045–2052.

    CAS  PubMed  Google Scholar 

  155. Tan GY, Chong CK, Eu KW, Tan PH. Gastrointestinal stromal tumor of the anus. Tech Coloproctol 2003;7:169–172.

    CAS  PubMed  Google Scholar 

  156. Miettinen M, Furlong M, Sarlomo‐Rikala M, Burke A, Sobin LH, Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the rectum and anus: a clinicopathologic, immunohistochemical, and molecular genetic study of 144 cases. Am J Surg Pathol 2001;25:1121–1133.

    CAS  PubMed  Google Scholar 

  157. Walsh TH, Mann CV. Smooth muscle neoplasms of the rectum and anal canal. Br J Surg 1984;71:597–599.

    CAS  PubMed  Google Scholar 

  158. Bernick PE, Klimstra DS, Shia J, et al. Neuroendocrine carcinomas of the colon and rectum. Dis Colon Rectum 2004;47: 163–169.

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  160. Nielsen OV, Jensen SL. Basal cell carcinoma of the anus—a clinical study of 34 cases. Br J Surg 1981;68:856–857.

    CAS  PubMed  Google Scholar 

  161. Espana A, Redondo P, Idoate MA, Serna MJ, Quintanilla E. Perianal basal cell carcinoma. Clin Exp Dermatol 1992;17: 360–362.

    CAS  PubMed  Google Scholar 

  162. Paterson CA, Young‐Fadok TM, Dozois RR. Basal cell carcinoma of the perianal region: 20‐year experience. Dis Colon Rectum 1999;42:1200–1202.

    CAS  PubMed  Google Scholar 

  163. Paget J. On disease of the mammary areola preceding cancer of the mammary gland. St. Barth Hosp Rep 1874;10:87–89.

    Google Scholar 

  164. Darier J, Couillaud P. Sur un cas de maladie de Pager de la region kerineo‐anal er scrotale. Ann de Dermatole dr de Syph 1893;4:25–31.

    Google Scholar 

  165. McCarter MD, Quan SH, Busam K, Paty PP, Wong D, Guillem JG. Long‐term outcome of perianal Paget's disease. Dis Colon Rectum 2003;46:612–616.

    PubMed  Google Scholar 

  166. Beck D. Paget's disease and Bowen's disease of the anus. Semin Colon Rectal Surg 1995;6:143–149.

    Google Scholar 

  167. Berardi RS, Lee S, Chen HP. Perianal extramammary Paget's disease. Surg Gynecol Obstet 1988;167:359–366.

    CAS  PubMed  Google Scholar 

  168. Tulchinsky H, Zmora O, Brazowski E, Goldman G, Rabau M. Extramammary Paget's disease of the perianal region. Colorectal Dis 2004;6:206–209.

    CAS  PubMed  Google Scholar 

  169. Jensen SL, Sjolin KE, Shokouh‐Amiri MH, Hagen K, Harling H. Paget's disease of the anal margin. Br J Surg 1988;75: 1089–1092.

    CAS  PubMed  Google Scholar 

  170. Sarmiento JM, Wolff BG, Burgart LJ, Frizelle FA, Ilstrup DM. Paget's disease of the perianal region: an aggressive disease? Dis Colon Rectum 1997;40:1187–1194.

    CAS  PubMed  Google Scholar 

  171. Beck DE, Fazio VW. Perianal Paget's disease. Dis Colon Rectum 1987;30:263–266.

    CAS  PubMed  Google Scholar 

  172. Besa P, Rich TA, Delclos L, Edwards CL, Ota DM, Wharton JT. Extramammary Paget's disease of the perineal skin: role of radiotherapy. Int J Radiat Oncol Biol Phys 1992;24:73–78.

    CAS  PubMed  Google Scholar 

  173. Marchesa P, Fazio VW, Oliart S, Goldblum JR, Lavery IC, Milsom JW. Long‐term outcome of patients with perianal Paget's disease. Ann Surg Oncol 1997;4:475–480.

    CAS  PubMed  Google Scholar 

  174. Grussendorf‐Conen EI. Anogenital premalignant and malignant tumors (including Buschke‐Lowenstein tumors). Clin Dermatol 1997;15:377–388.

    PubMed  Google Scholar 

  175. Trombetta LJ, Place RJ. Giant condyloma acuminatum of the anorectum: trends in epidemiology and management—report of a case and review of the literature. Dis Colon Rectum 2001; 44:1878–1886.

    CAS  PubMed  Google Scholar 

  176. Chu QD, Vezeridis MP, Libbey NP, Wanebo HJ. Giant condyloma acuminatum (Buschke‐Lowenstein tumor) of the anorectal and perianal regions. Analysis of 42 cases. Dis Colon Rectum 1994;37:950–957.

    CAS  PubMed  Google Scholar 

  177. Frisch M, Smith E, Grulich A, Johansen C. Cancer in a population‐based cohort of men and women in registered homosexual partnerships. Am J Epidemiol 2003;157:966–972.

    PubMed  Google Scholar 

  178. Gates AE, Kaplan LD. AIDS malignancies in the era of highly active antiretroviral therapy. Oncology (Huntingt) 2002;16: 441–451, 456, 459.

    Google Scholar 

  179. Yuhan R, Orsay C, Del PinoA, et al. Anorectal disease in HIV‐infected patients. Dis Colon Rectum 1998;41:1367–1370.

    CAS  PubMed  Google Scholar 

  180. Place RJ, Huber PJ, Simmang CL. Anorectal lymphoma and AIDS: an outcome analysis. J Surg Oncol 2000;73:1–4; discussion 4–5.

    CAS  PubMed  Google Scholar 

  181. Smith DL 2nd, Cataldo PA. Perianal lymphoma in a heterosexual and nonimmunocompromised patient: report of a case and review of the literature. Dis Colon Rectum 1999;42: 952–954.

    PubMed  Google Scholar 

  182. Nigro ND. Multidisciplinary management of cancer of the anus. World J Surg 1987;11:446–451.

    CAS  PubMed  Google Scholar 

  183. Habr‐Gama A, da Silva e Sousa AH, Nadalin W, et al. Epidermoid carcinoma of the anal canal: results of treatment by combined chemotherapy and radiation therapy. Dis Col Rectum 1989;32:773–777.

    Google Scholar 

  184. Sischy B, Scotte Doggett RL, Krall JM, et al. Definitive irradiation and chemotherapy for radiosensitization in management of anal carcinoma: interim report on radiation therapy oncology group study no. 8314. J Nat Canc Inst 1989;81:850–856.

    CAS  Google Scholar 

  185. Cho CC, Taylor CW III, Padmanabham A, et al. Squamous‐cell carcinoma of the anal canal: Management with combined chemo‐radiation therapy. Dis Colon Rectum 1991;34:675–678.

    CAS  PubMed  Google Scholar 

  186. Lopez MJ, Myerson RJ, Shapiro SJ, Fleshman JW, Fry RD, Halverson JD, Kodner IJ, Monafo WW. Squamous cell carcinoma of the anal canal. Am J Surg 1991;162:580–584.

    CAS  PubMed  Google Scholar 

  187. Doci R, Zucaki R, Bombelli L, Montalto F, Lomonica G. Combined chemoradiation therapy for anal cancer: a report of 56 cases. Ann Surg 1992;215:150–156.

    CAS  PubMed  Google Scholar 

  188. Johnson D, Lipsett J, Leong L, Wagman LD, Terz JJ. Carcinoma of the anus treated with primary radiation therapy and chemotherapy. Surg Gynecol Obstet 1993;177: 329–334.

    CAS  PubMed  Google Scholar 

  189. Tanum G, Tweit KM, Karlsen KO. Chemo‐radiatiotherapy of anal carcinoma: Tumor response and acute toxicity. Oncology 1994;50:14–17.

    Google Scholar 

  190. Beck DE, Karulf RE. Combination therapy for epidermoid carcinoma of the anal canal. Dis Colon Rectum 1994;37: 1118–1125.

    CAS  PubMed  Google Scholar 

  191. Smith DE, Shah KH, Rao AR, Frost DB, Latino F, Anderson PJ, Peddada AV, Kagan AR. Cancer of the anal canal: Treatment with chemotherapy and low dose radiation therapy. Radiology 1994;191:569–572.

    CAS  PubMed  Google Scholar 

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Welton, M.L., Varma, M.G. (2007). Anal Cancer. In: Wolff, B.G., et al. The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-36374-5_35

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