Cryosurgical treatment for anorectal cancer. A method of palliative or adjunctive management.

Thirty-two patients with anorectal cancer were treated with cryosurgery from April 1974 to August 1985. The purpose of the treatment was to provide palliative benefits to 27 patients. In one group (17 patients) who did have previous surgery, cryosurgery was used for the predominant symptoms of melena and/or obstruction. In the postoperative period, local bleeding was minimal, and palliation was judged significant. The survival time of this group ranged from 1 month to 18 months. In another group (10 patients) in whom recurrent cancer followed previous operative treatment, cryosurgery was used to control the local invasion and tumor bulk. All of these patients died within 17 months after recurrence was discovered. Nevertheless, treatment was judged to provide significant palliation. A small group (five patients) was treated with the intent to cure, and cryosurgical techniques were used as an adjunct to surgical excision. Four patients survived more than 8 years after the operation. Two of these patients died of illnesses other than cancer. The local destruction of an anorectal cancer by cryosurgery in these patients provided effective control of the tumor. Bleeding was controlled, and tumor bulk was reduced in size. All patients were treated without any complications caused by cryosurgery. This experience indicates that the cryosurgical technique provides therapeutic benefits for selected patients with anorectal cancer, especially those of high surgical risk.