The malignant anal tumor is relatively rare, and abdominoperineal resection was mainstream of the treatment in the past. But, in recent, multimodality treatment of radiotherapy and systemic chemotherapy was tried, and good results were reported
in
many
papers.
So, we reviewed the 71 cases of the primary malignant anal tumors which were treated at the department of general surgery, Presbyterian Medical Center, chonju, from Jan, 1963 to Dec. 1990.
@ES The results were as follows:
@EN 1) The incidence of the malignant anal tumor was 0.3% of total malignant tumors and 6% of coloanorectal cancer.
2) The ratio of male to female was 7.9 : 1, and peak age was 50th years old(N : 24, range: 31-78 years old).
3) The symptom and signs were bleeding, pain, constipation, mass, tenesmus, etc, in order.
4) 41 patients(58% of all) had the past history of hemorrhoid, abscess, prolapse, fissure, fistula, rectal cancer before the diagnosis as anal cancer, and the seventeen patients(24% of all) had the history of sclerosing agent injection therapy.
5) The primary site of the malignant anal tumors were histological anal margin; 36 cases(51%), histological anal canal; 22 cases(31%), and undefined; 13 cases, and pathologic diagnoses of the malignanat anal tumors were epidermoid carcinoma; 62
cases(87%), adenocarcinoma: 5 cases(7%), cloacogenic carcinoma; 2 cases mixed carcinoma; 1 cases, and malignant melanoma; 1 case.
6) The clinical stages(by AJCC, 1989) were classified as stage I; 2 cases, stage II; 14 cases, stage III; 37-cases(52% of all), stage IV; 7 cases. The treatments were composed of palliative treatment; 40 cases(biopsy; 28 cases, palliative
colostomy; 7
cases, palliative radiotheray; 3 cases, electrofulguration; 2 cases) and curative treatment; 31 cases(abdominoperineal resection; 7 cases, APR with radiotherapy; 11 cases, curative radiotherapy; 5 cases, and chemoradiotherapy; 8 cases).
7) The overall five year survival rate according to treatment was 0% in pahiative treatment and 53% in curative treatment, and the five year survival rate according to curative treatment modality was 100% in chemoradiotherapy, 55% in APR with
radiotherapy, 43% in APR only, 40% in curative radiotherapy.
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