Squamous cell carcinoma of the anal canal: a review of the aetiology, presentation, staging, prognosis and methods available for treatment
Squamous cell carcinoma of the anal canal: a review of the aetiology, presentation, staging, prognosis and methods available for treatment
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DOI：
10.1071/sh12010
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发表时间：
2012-01-01
期刊：
影响因子：
1.6
通讯作者：
Wu, James S.
中科院分区：
文献类型：
--
作者：
Szmulowicz, Ursula M.;Wu, James S.
肛门癌是一种罕见的恶性肿瘤，大多数病例由鳞状细胞癌组成。这种疾病发病率的增加反映了人类乳头瘤病毒传播的增加，这种病毒是大多数肿瘤的病原体。腹会阴切除术（APR），曾经是主要的治疗模式，已取代括约肌保留联合放化疗作为一线治疗。然而，外科医生继续在肛门癌患者的诊断和治疗后监测的多学科管理中发挥作用。前哨淋巴结活检可以识别临床和影像学阴性的腹股沟淋巴结患者，这些患者将受益于腹股沟照射。在极少数病例中，有争议的局部切除方法被用作主要治疗方法，通常与放射和化学疗法结合使用。原发性放化疗后持续性或复发性肛门癌的管理仍然是一个问题，目前只有补救性APR才有可能治愈。人乳头瘤病毒疫苗的引入为根除这种疾病提供了令人兴奋的潜力。
Anal cancer is an uncommon malignancy, with the majority of cases comprised of squamous cell carcinomas. The increasing incidence of this disease reflects a rise in the transmission of the human papillomavirus, the causative organism of most tumours. Abdominoperineal resection (APR), once the primary mode of treatment, has been supplanted by sphincter-saving combination chemoradiation as the first-line therapy. However, surgeons continue to play a role in the multidisciplinary management of patients with anal cancer for diagnosis and post-treatment surveillance. Sentinel node biopsy may identify patients with clinically and radiographically negative inguinal lymph nodes who will benefit from groin irradiation. In very select cases, the controversial means of local excision has been employed as primary treatment, often in conjunction with radiation and chemotherapy. The management of persistent or recurrent anal cancers following primary chemoradiation remains a concern, for which only salvage APR currently offers the possibility of a cure. The introduction of human papillomavirus vaccines presents the exciting potential for the eradication of the disease.