Patients with Incidental Anal Squamous Cell Carcinoma Did Not Have Poorer Outcomes Than Patients with Primary Concurrent Chemoradiotherapy

依照我們單一醫學中心35年的經驗統計，意外被小手術切除肛門鱗狀細胞癌的病人並不會有比較差的預後

江梓維(Tzu-Wei Chiang) ； 陳明正(Ming-Cheng Chen) ； 吳致瑩(Chin-Ying Wu) ； 陳周斌(Chou-Pin Chen) ； 趙德馨(Te-Hsin Chao) ； 馬秀峰(Hsiu-Feng Ma) ； 陳周誠(Chou-Chen Chen) ； 蔣鋒帆(Feng-Fan Chiang)

《中華民國大腸直腸外科醫學會雜誌》 29卷2期 (2018/06) Pp. 77-83

https://doi.org/10.6312/SCRSTW.201806_29(2).10627

摘要

Background. Concurrent chemoradiotherapy (CCRT) is standard first-line treatment for anal squamous cell carcinoma (SCC). Some cases might be misdiagnosed as hemorrhoids, anal fistulas, or other anal tumors. Incidental findings of anal SCC after minor surgery (wide excision, hemorrhoidectomy, or fistulectomy) also sometimes occurs. We compared the outcomes of incidental anal SCC patients with patients initially treated with CCRT. Materials and Methods.We retrospectively reviewed the charts of 41 patients diagnosed with anal SCC between 1982 and 2016. Tumor stage, treatment, overall survival, 5-year survival, and recurrence-free survival were compared. Results. The 5-year-survival rate of all patients was 66%; recurrence-free survival was 57%. The 5-year survival rate of patients preoperatively treated with CCRT was 61%; recurrence-free survival was 49%. Twentyfive patients underwent surgery and 16 patients (classified as having Incidental Anal SCC) underwent a fistulectomy, hemorrhoidectomy, or wide excision before being diagnosed with anal SCC. The 5-year survival rates of patients with incidental SCC and of patients treated with CCRT as first-line therapy were 76%, n = 15 vs. 61%, n = 16, respectively; p = 0.044. In our retrospective study, patients with incidental anal SCC did not have a poorer prognosis than did patients given CCRT as a first-line treatment. Conclusions. The 5-year survival of incidental SCC patients was not worse than that of anal SCC patients initially treated using CCRT.

關鍵字

Anal squamous cell carcinoma ； Incidental carcinoma

並列摘要

背景：同步放化療是目前治療肛門鱗狀細胞癌的第一線標準治療，但有一部份病人的表現不很典型，在確定診斷前有可能被小手術切除（像是痔瘡切除，瘻管切除或是廣泛切除）。在這個回顧性的研究我們統計這群病人和第一線就接受同步放化療的病人做比較。方法：從1982年到2016年，總共41個病人被診斷為肛門鱗狀細胞癌。我們調閱了他們的病歷。他們的期別、治療、整體存活率、五年存活率、無復發存活率都被收集並比較。結果：所有病人的5年存活率是66%，5年的無復發存活率是57%。以同步放化療為第一線治療的病人5年存活率是61%，5年的無復發存活率是49%。有25個病人是手術為第一線治療，其中的15人為確立診斷前接受了小手術（像是痔瘡切除，瘻管切除或是廣泛切除）。這群病人被定義為意外被小手術切除。他們的5年存活率和以同步放化療為第一線治療的病人比較為 (76%, n = 15 vs. 61%, n = 16, p = 0.044)。在這個回顧性的研究意外被小手術切除肛門鱗狀細胞癌的病人和以同步放化療為第一線治療的病人相比，並不會有比較差的預後。結論：雖然臨床上會遇到被小手術切除肛門鱗狀細胞癌的病人，如果病人有接受後續治療，和以同步放化療為第一線治療的病人比，我們醫院的統計結果顯示預後不會比較差。

並列關鍵字

肛門鱗狀細胞癌

參考文獻

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