In spite of its apparent rarity, 0.34% of total malignant tumors and 6.1% of the colo-recto-anal malignancies in our data base, malignant anal tumors are of interest to clinicians because of newly developed treatment modalities. 82 patients with
primary
anal cancer, confirmed by pathologic study between 1964 and 1993 at Presbyterian medical center in Chonju were analyzed. The cancers detected were epidermoid carcinoma (66cases, 80.5%), adenocarcinoma(11 cases, 13.4%), cloacogenic carcinoma (4
cases,
4.8%) and malignant melanoma(1 case, 1.3%) 40 cases (48.8%) had their primary lesion on the histologic anal margin and 31 cases(37.8%) had it on the histologic anal canal. In 11 cases, the primary site could not be defined. 46 patients (56.1%)
had
a
history of benign anal disease.
Adenocarcinoma increased in proportion, to over the last 10 years(24% of the anal cancer), the recent increase of colorectal cancer in Korea. 9 of 11 cases occured in the anal canal. The prognosis for denocarcinoma was worse than that for
epidermoid
based on 5-year survival rate (55% vs. 24%).
Abdominoperineal resection was the primary surgery for epidermoid cancer. It has been replaced modalities to preserve anal function in the last 10 years, and the 5-year survival rate was increased as 13%, 47%, and 73% every 10 years, accompanied
with
the increasing tenants of chemoradiation therapy in our series. But 0% of 21 cases of palliative measure, 80.8% of 12 cases of chemoradiation therapy, 5.3% of 9 cases of APR only, 46.3% of 7 cases of APR with XRT, and 50% of 4cases of XRT showed
5-year
survival. The prognostic factors emerged in our study were tumor size, clinical stage, node involvement, and the treatment modalitiy. First three has the significance in 5-year survival rate between T 2 and T3(P<0.05), stage 2 and stage 3(p<005),
and N0
and N1(P,0.05)
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