Laser Cytoreduction as Part of Multimodality Therapy for Squamous Cell Carcinoma of the Anus: A Case Report

The treatment of anal canal epidermoid cancer has changed dramatically during the last two decades, exemplified by the excellent results of primary chemoradiotherapy compared with traditional radical surgical resection. Despite this progress, the management of large (>5 cm) tumors remains controversial. We report a case of advanced (tumor size 8 cm, lymphatic metastases; Stage T₄N₂), moderately differentiated squamous cell carcinoma of the anal canal which was managed by CO₂ laser ablation with followup combined chemoradiotherapy. The patient has remained well in the 12 months since initial treatment with excellent anal sphincter function and no evidence of distant metastases or residual disease on biopsy. We conclude that combined debulking and chemoradiotherapy should be considered in patients with locally advanced, unfavorable squamous cell cancer of the anal canal.