Hépato-Gastro & Oncologie Digestive
MENUManagement of anal cancer in 2017 Volume 24, issue 1, Janvier 2017
- Key words: anal canal cancer, HPV, HIV, radiotherapy, chemotherapy
- DOI : 10.1684/hpg.2016.1386
- Page(s) : 45-54
- Published in: 2017
Squamous cell carcinoma is the main type of anal cancer. It is a rare cancer, its frequency increases in patients infected with HIV (especially men who have sex with men) since the advent of active antiretroviral therapy. HPV infection is found in 90% of cases. The initial workup includes 18-FDG PET/CT, pelvic MRI, and thoraco-abdominopelvic CT-scan; anorectal ultrasonography remains interesting for small tumours. HIV-related comorbidities and other HPV-induced cancers must be also searched. The reference treatment for localized forms is radiation therapy combined in most cases with chemotherapy. Systemic chemotherapy is the standard treatment of metastatic forms. Salvage surgery is indicated in case of local progression or recurrence after chemoradiotherapy. The anti-EGFR antibodies and immunotherapy could represent interesting therapeutic perspectives.