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만성 치루에서 기인한 항문암의 임상 양상과 특징

The Clinical Features and Charateristics of anal Cancer Arising from Chronic Fistula- in-ano

대한대장항문학회지 2002년 18권 6호 p.373 ~ 378
손병호 ( Son Byung-Ho ) - 성균관대학교 의과대학 강북삼성병원 외과학교실

한원곤 ( Han Won-Kon ) - 성균관대학교 의과대학 강북삼성병원 외과학교실
김흥대 ( Kim Heung-Dae ) - 성균관대학교 의과대학 강북삼성병원 외과학교실
김광연 ( Kim Kwang-Yeon ) - 송도병원 외과

Abstract


Purpose: The incidence of unhealed chronic fistula is about 7% and the cancer can occur in the longstanding unhealed fistula. The most of the cancer is mucinous adenocarcinoma. The report is diverse about treatment, adjuvant chemotherapy and prognosis. The purpose of this study is review of the clinical characteristics and survival of the anal cancer arising from chronic fistula-in-ano.

Methods: The number of patients was 10. The diagnosis is made under pathological examination at the Kanbuk Samsung Hospital from 1983 to 2000. The retrograde study was done with patients’ records and telephone questionnaire. The survival rate was calculated with Kaplan-Meier method.

Results: All patients were male. The patients had symptoms of anal discharge and anal swelling suggesting the anal fistula. The patients had history of anal surgery. The external openings were multiple. Seven patients had mucinous
adenocarcinoma.The prognosis was poor. Among 8 patients’ follow-up data, except one patient, 7 patients died within 43 months.

Conclusions: The anal cancer can occur in longstanding unhealed fistula. In our series, all patients were male, and they had multiple opening fistula. The patient who had small size tumor have only survived. Through meticulous exploring and deep biopsy of the fistula, early detection is best method to treat the anal cancer arising from chronic fistula-in-ano.

키워드

항문암;만성 치루;예후;조기검진
Anal cancer;Chronic fistula-in-ano;Prognosis;Early detection
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