RARE CANCER NETWORK www.rarecancer.net Dr Créhange Gilles Centre Georges François Leclerc Department of Radiation Oncology 1 Rue du Professeur Marion, 21000 Dijon FRANCE Phone: +33.3184.108.40.206 Fax: +33.3220.127.116.11 Dijon, 27.11.2007 To: members of the Rare Cancer Network Concerning: new study proposal – Anal Intraepithelial Neoplasia (AIN) Dear Colleagues, Despite the small number of patients affected by carcinoma of the anal canal, it remains one of the most challenging cancers to treat. AIN is a premalignant condition that can progress to invasive carcinoma through different grades of severity of the disease. The incidence of AIN has increased significantly in the last decades. It is often diagnosed on the analysis of a sample excision of clinically benign anal lesions that are incidentally found to be AIN. Treatment is aimed at eradicating AIN and preventing anal cancer with minimal disturbance of anal function, particularly continence to stools and flatus. However, at the present time, it is difficult to formulate a defined management strategy because of the uncertain natural history and malignant potential of AIN and, not least, the lack of an effective treatment modality. Several treatment modalities have been described for AIN, including immunomodulation, HPV-based vaccines, locally ablative procedures and surgery. The success of such treatments depends largely on depth of treatment relative to the extent of AIN involvement of the skin appendages. In cases of more severe and localized lesions (AIN II and AIN III), surgical resection should be considered if the predictive postoperative morbidity is low. A French multicenter retrospective study on early stage T1 or Tis tumours have reported excellent local control with small volume and moderate dose of irradiation. Of the 69 patients included in this study, only 12 patients had AIN. None of the 9 patients with Tis treated by excision followed by RT developed local recurrence whereas one of the 3 patients treated by excision alone developed local recurrence. Patients with AIN are generally excluded from prospective or retrospective studies, and most institutions have treated few cases of these Tis cancers with adjuvant or exclusive radiotherapy. There is a need for a large retrospective study in patients with AIN to further our understanding of this disease and to evaluate the outcome with radiotherapy. Looking forward to your collaboration, Yours sincerely, Dr Gilles Créhange e-mail: [email protected] Please complete the attached interest form and return it to the above e-mail address or to fax nr. +33.318.104.22.168 RARE CANCER NETWORK www.rarecancer.net Dr Créhange Gilles Centre Georges François Leclerc Department of Radiation Oncology 1 Rue du Professeur Marion 21000 Dijon FRANCE Phone: +33.322.214.171.124 Fax: +33.3126.96.36.199 INTEREST FORM Please return this form by fax or e-mail if possible by December 15th , 2007 to: Fax: E-mail: +33.3188.8.131.52 [email protected] Name: Institution: Town: Fax: e-mail: □ Yes, I am interested in participating in this retrospective analysis and I can send information on approximately _____ patients.