The cancer of the anus and rectum occupies a high proportion in cancers of gastrointestinal tract. It can be detected relatively simply by digital examination and endoscopy. For the treatment of the cancer, various surgical methods have been used since Miles´ abdominoperineal resection was introduced in 1908. This paper deals with a clinical review on 127 cases of anorectal cancer treated at Seoul National University Hospital during the eight year period, from 1959 to 1967.
The cancer occurred 1.67 times more common in males than in females. There was a peak incidence between the ages of 40 and 60 years. The tumor occupied the lower third of the rectum in 67 per cent of the cases and the anus in 23 cases, or 18 per cent. The duration of symptoms was six months in 50 cases and between six months to one year in 52 cases. One case with severe metastatic condition had had symptoms for 20 years.
The most common cell type was adenocarcinoma, being encountered in 89 cases. The nine cases of squamous cell carcinoma all involved the anus. Local and distant lymphatic spread was found in 44 cases and distant metastasis in 39 cases, of which the most common organ involved was the liver, comprising 14 cases. Radical abdominoperineal resection was performed in 69 cases, of which 48 cases had sphincter preserving operation. Colostomy was performed in 38 cases as palliative measure. Eleven cases had no operation.
Overall operative mortality was 4.3 per cent and postoperative complications were common in the order of anal stricture, sigmoid retraction, fistula formation and lieus. Of 48 the cases on which followup results could be assessed, nineteen patients died within three years after surgery. The overall three-year survival rate was 61.2 per cent. Sphincter function was restored in four to five weeks after sphincter preserving operation. The sphincter condition was excellent in 40 per cent, good in 31.4 per cent, fair in 14.3 per cent and poor in 14.3 per cent of the cases.
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