33 Cases of Anal Cancer

Ahn, Byung Kwon; Park, Yong Rae; Baek, Sung Uhn

Abstract

PURPOSE: Malignant disease of the anus is rare. Abdominoperineal resection was formerly considered to be the treatment of choice. But, in recent, less ablative and more effective combined therapeutic modalities have been developed.
METHODS
we analyzed 33 patients who were diagnosed and treated as anal cancers at the Department of Surgery, Gospel Hospital, Kosin Medical Collage, from July 1, 1988 to Nov. 30, 1997.
RESULTS
The ratio of male to female was 1.4:1 and mean age was 56.7 years old. Twenty-two (84.8%) of these cancers were located in the anal canal and 5 (15.2%) in the anal margin. Three main histologic types of the anal cancers were identified: squamous cell carcinoma was the most common lesion, accounted for 17 cases (51.1%), adenocarcinoma accounted for 8 cases (24.2%), malignant melanoma accounted for 8 cases (24.2%). The overall 3-year survival rate and 5-year survival rate of anal cancer were 54.1%, 41.7%. Eleven patients with squamous cell carcinoma were treated curatively: 6 patients were treated with chemoradiotherapy, 3 patients with abdominoperineal resection, one patient with chemoradiotherapy and abdominoperineal resection, one patient with local excision.
CONCLUSION
In survival rate, there were no significant differences between chemoradiotherapy group and surgical treatment group. In squamous cell carcinomas, chemoradiotherapy had anal sparing benefit without loss of survival. On univariate analysis, T, N, type of treatment, histologic type had no statistical significances on survival. On multivariate analysis, location of lesion and distant metastasis had statistical significances.