Fax: +33.380.73.75.18

Dr Créhange Gilles
Centre Georges François Leclerc
Department of Radiation Oncology
1 Rue du Professeur Marion, 21000 Dijon
Phone: +33.380.73.75.18
Fax: +33.380.73.75.18
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. +33.380.73.75.18
Dr Créhange Gilles
Centre Georges François Leclerc
Department of Radiation Oncology
1 Rue du Professeur Marion
21000 Dijon
Phone: +33.380.73.75.18
Fax: +33.380.73.75.18
Please return this form by fax or e-mail if possible by
December 15th , 2007 to:
[email protected]
Yes, I am interested in participating in this retrospective analysis
and I can send information on approximately _____ patients.