Aigner Felix, Siegel Robert
Chirurgische Abteilung, Krankenhaus der Barmherzigen Brüder Graz, Graz, Österreich.
Charité-Universitätsmedizin Berlin, Berlin, Deutschland.
Chirurgie (Heidelb). 2023 Oct;94(10):890-898. doi: 10.1007/s00104-023-01849-2. Epub 2023 Apr 12.
Despite the increasing incidence, anal cancer is still a rare gastrointestinal tumor, so that due to the broadness of the primary care there is often little experience in the care of affected patients. Squamous cell cancer (SCC) constitutes more than 90% of all anal cancers and is nearly always associated with an infection by the human papillomavirus. This article concentrates on SCC of the anal canal and anal margin. The focus is on the primary diagnostics, surgical treatment, response assessment and aftercare. Treatment is carried out according to the decision of the interdisciplinary tumor board, independent of the tumor location and stage. Anal margin cancer in stage I (and IIa) can be successfully treated by an R0 excision. Combined chemoradiotherapy as the standard treatment in stages II and III is briefly summarized. The article is essentially based on the new German S3 guidelines on anal cancer.
尽管肛管癌的发病率在上升,但它仍然是一种罕见的胃肠道肿瘤,因此由于初级保健范围广泛,在照顾受影响患者方面往往经验不足。鳞状细胞癌(SCC)占所有肛管癌的90%以上,几乎总是与人乳头瘤病毒感染有关。本文主要关注肛管和肛缘的鳞状细胞癌。重点是初步诊断、手术治疗、疗效评估和后续护理。治疗根据多学科肿瘤委员会的决定进行,与肿瘤位置和分期无关。I期(和IIa期)的肛缘癌可通过R0切除成功治疗。简要总结了II期和III期联合放化疗作为标准治疗方法。本文主要基于德国新的肛管癌S3指南。