Treatment of carcinoma of the rectum and squamous carcinoma of the anus by combination chemotherapy, radiotherapy and operation.

After reviewing the recent literature, a protocol has been formulated at this hospital for patients with carcinomas of the anus and rectum larger than 5 centimeters in diameter. The protocol used in this study was a combination of chemotherapy and radiation therapy, followed four to six weeks later by abdominoperineal resection. This approach has been demonstrated clearly to be of value. All lesions decreased in size. In more than half the number of patients, the primary lesion was reduced by more than 50 per cent; 78 per cent of the patients had no nodes at operation. In ten patients, there was no tumor and, in 26, only minimal tumor. We have the impression that, if operation were delayed another two weeks, perhaps even some of these patients would have had no tumor. It is too early to be able to consider five and ten year results. However, at the same time, present results demonstrate most effectively the value of combined interdisciplinary therapy by means of the available modalities in the management of carcinoma of the rectum and anus.