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항문암 33예

33 Cases of Anal Cancer

대한대장항문학회지 1998년 14권 4호 p.743 ~ 749
안병권 ( Ahn Byung-Kwon ) - 고신대학교 의과대학 일반외과교실

박용래 ( Park Young-Rae ) - 고신대학교 복음병원 외과학교실
백승언 ( Baek Sung-Uhn ) - 고신대학교 복음병원 외과학교실

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.

키워드

Anal cancer;Chemoradiotherapy;Preservation of anus
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