Multimodality approach to surgical management of locally advanced XXXX of the anorectum.

@entity1 @entity5 @entity957 @entity1138 @entity3 @entity1487
Seven @entity1 (five female, two male) had locally advanced @entity957 of the anal canal. Three @entity1 had recurrent or persistent disease previously treated and four had advanced primary @entity5 . Five @entity1 had groin node @entity3 . The treatment protocol consisted of chemotherapy with continuous 5-day infusion of @entity1487 , 750 mg/m2, and @entity1138 , 15 mg/m2, by bolus injection and radiation 3000 rads. All @entity1 received one or two cycles of chemotherapy pre-operatively and four (not previously irradiated) received radiation. Tumor regression greater than 50% occurred in five @entity1 , minor regression (25-50%) occurred in one @entity1 and one @entity1 showed no regression (on chemotherapy alone). All @entity1 had total resection of all gross @entity5 with microscopic clear margins and five had groin dissection. One @entity1 had no @entity5 in specimen and one @entity1 had a microscopic focus only. Four of five @entity1 had residual nodal metastases at groin dissection. Currently three @entity1 are free of disease at 24, 24, and 26 months. Two @entity1 died with disease at 6 months and 34 months, and two @entity1 died of other causes while still free of disease, at 4 and 5 months after resection. Multimodality therapy of locally advanced epidermoid @entity5 of anal canal can provide effective control and palliation of many of these @entity5 and, in some, possibly effect cure.
