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Anorectal cancer
Last reviewed: 23.04.2024
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Most often anorectal cancer is represented by adenocarcinoma. Ploskokletochnaya (neorogovevayuschie epithelial or basal cells) carcinoma of the anorectal zone is 3-5% of the cancer lesions of the distal part of the colon.
Less common are basal cell carcinoma, Bowen's disease (intradermal carcinoma), extramammary Paget's disease, cloacogenic cancer and malignant melanoma. Other tumors include lymphoma and various forms of sarcoma. Metastasis occurs through the lymphatic channels of the rectum and into the inguinal lymph nodes.
[What causes anorectal cancer?
Risk factors include human papillomaviras (HPV) infection , chronic fistulas, anal skin irradiation, leukoplakia, lymphogranuloma venereal and genital warts. Men who are homosexuals who practice anal sex are at increased risk. Patients with HPV infection may experience dysplasia in a slightly altered or apparent normal epithelium of the anal canal ("anal intraepithelial neoplasia", histological type I, II or III). These changes are more typical for HIV-infected patients, especially male homosexuals. With a higher degree of change, progression to invasive carcinoma is observed. It is not known whether long-term results improve early detection and elimination of infection; therefore, the recommendations of the screening survey are not defined.
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Treatment of anorectal cancer
Widespread local excision is often a satisfactory method of treating perianal carcinoma. Combined radiation and chemotherapy lead to a high degree of cure in the case of squamous cell anal and cloacogenic tumors. If radiotherapy and chemotherapy do not lead to complete regression of the tumor and there is no metastasis outside the irradiation zone, abdominal perineal resection is indicated.