TITLE

Anal Carcinoma or 'Just Hemorrhoids'?

AUTHOR(S)
Winburn, Ginger B.
PUB. DATE
November 2001
SOURCE
American Surgeon;Nov2001, Vol. 67 Issue 11, p1048
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Cancers of the anal margin and anal canal are extremely rare and often misdiagnosed. Only one to two per cent of large bowel cancers arise in this area. Current management of these cancers includes surgery, combined chemoradiation, or both. From January 1985 through July 2000, 50 patients were diagnosed with anal cancer at two institutions. This retrospective review includes all available cases of anal cancer including all histologies. Patient charts were analyzed for diagnosis, staging, treatment, survival, and recurrence rate. The patients ranged in age from 27 to 92 years (median age 51 years; mean age 52.8 years); there were 22 men and 28 women. The pathologic diagnosis included 44 (88%) with squamous cell carcinoma, three (6%) with melanoma, two (4%) with adenocarcinoma, and one (2%) with Paget's disease. At presentation nine (18%) were classified as stage 0, five (10%) stage I, 21 (42%) stage II, eight (16%) stage III, and seven (14%) stage IV. Mean follow-up data were available on 100 per cent of the patients. Chemoradiotherapy was the primary treatment modality in 25 patients (50%). Ten patients (20%) underwent abdominoperineal resection (APR) in the study. Three patients (6%) received an APR as primary treatment, three (6%) in combination with chemoradiation, and four (8%) for salvage therapy. Fourteen patients (28%) underwent wide local excision (WLE) as the primary treatment. Two patients (4%) underwent WLE plus chemoradiation therapy. One patient (2%) underwent WLE and chemotherapy. There were 18 deaths (36%) in this series. Thirteen patients (26%) died of anal cancer; the average time to death from diagnosis was 13.2 months. Three of these deaths were in patients with melanoma who presented with stage IV disease. Thirty-two patients (64%) are alive, and 30 (60%) of these patients are free of disease (mean time since diagnosis 32.5 months, range 2-151 months). Six patients (12%) had recurrence after treatment (mean time to recurrence 12.6 mont...
ACCESSION #
5562955

 

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