Robb Bruce W, Mutch Matthew G
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110-1010, USA.
Clin Colon Rectal Surg. 2006 May;19(2):54-60. doi: 10.1055/s-2006-942345.
Anal cancers are rare tumors with only an expected 4000 new diagnoses in 2005. The majority of these are epidermoid or squamous cell cancers. Despite the rarity of this disease, great advances have been made in its understanding and treatment. The human papillomavirus (HPV), immunosuppression for solid organ transplantation, the human immunodeficiency virus (HIV), and sexual practices are changing the demographics of the disease from elderly women to young men who have sex with men and young women infected with HPV and HIV. The treatment of these malignancies was radically changed with Dr. Nigro's description in 1974 of the use of a nonoperative treatment strategy. Today, radiochemotherapy represents first-line therapy and the role of surgery has been largely relegated to that of salvage therapy for treatment failures of nonoperative management.
肛管癌是罕见肿瘤,2005年预计仅有4000例新诊断病例。其中大多数为表皮样癌或鳞状细胞癌。尽管这种疾病罕见,但在其认识和治疗方面已取得了巨大进展。人乳头瘤病毒(HPV)、实体器官移植的免疫抑制、人类免疫缺陷病毒(HIV)以及性行为正在改变该疾病的人口统计学特征,从老年女性转变为男男性行为者以及感染HPV和HIV的年轻女性。1974年尼格罗博士描述了一种非手术治疗策略,这彻底改变了这些恶性肿瘤的治疗方式。如今,放化疗是一线治疗方法,而手术的作用在很大程度上已沦为对非手术治疗失败的挽救性治疗。