“…Application of topical agents, especially podophyllin, has been well documented to be ineffective 6,10,17,26,45,46,48 and is associated with disease recurrence. 16,47,48 In such cases, fecal diversion and abdominal-perineal resection, in combination with either wide local excision 47 or radiation therapy with concomitant chemotherapy, 16 are required to obtain satisfactory results. Disappointing results similar to application of topical agents have occurred from the use of either oral methotrexate 48 or 5-fluorouracil alone 48 or from a combination of 5-fluorouracil, mitomycin, and radiation therapy.…”