Lymphadenectomy versus chemoradiation for treatment of inguinal lymph nodes metastases from anal epidermoid carcinoma: LTP63

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Aim:With the aim to compare results of inguinal lymphadenectomy (ILA) and chemoradiation (CRT) for inguinal lymphnodes metastases (mILN) from anal carcinoma (AC) retrospective study was undertaken.Method:Of 146 consecutive patients (1996-2009) with AC 15 (10.3%) had synchronous mILN and six had metachronous mILN. All 21 patients were women at mean age 58 ± 10.8 (range 41-79). ILA wasprimary treatment in four patients with synchronous mILN and four patients with metachronous mILN. CRT was used in 11 cases of synchronous mILN and two cases of metachronous mILN.Results:Morbidity rate after ILA was 50% and local control (LC) rate at 5 years was 6/8 (75%). Two local recurrence treated by CRT but secondary LC achieved for one. No significant toxicity developed after CRT and complete response of mILN was achieved in 9/13 (69.2%), but only 6/13 (46.2%) had LC at 3 year. No difference in overall 5-year survival between ILA and CRT was obtained: 43.0% vs 47.0% (P = 0.9). Tendency toward better 5-year survival of treatment for metachronous comparing to synchronous mILN was found: 60.0% vs 40.8% (P = 0.1).Conclusion:The effectiveness of ILA and CRT for mILN is similar. Time of mILN appearance is most important factor of survival.

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