The Oncologic Outcome of Anal Squamous Cell Carcinoma and Adenocarcinoma

肛門癌的治療及預後分析

蔡宗芸(Tzong-Yun Tsai) ； 蔡文司(Wen-Sy Tsai)

《中華民國大腸直腸外科醫學會雜誌》 33卷3期 (2022/09) Pp. 156-162

https://doi.org/10.6312/SCRSTW.202209_33(3).11115

摘要

Introduction. Most patients with anal cancer were recommended to treat with chemoradiotherapy. However, some patients may still receive surgery in the hope of improving oncologic outcomes. In this study, we analyze the oncologic outcome of patients with anal cancer from different types of treatment and review the literature. Method. We collected patients with anal cancer and have been treated in the colorectal department in Chung Gung Memorial Hospital from 1997 to 2020. Clinicopathologic variables were collected. We performed univariate and multivariate analyses for overall and disease-free survival. For subgroup analysis, all patient was classified into three groups according to treatment type: operation only, CCRT only, and operation plus CCRT. Result. In univariate analysis, patients with SCC have significantly better overall survival than adenocarcinoma. Patients with distant metastasis have significantly worse overall survival and disease-free survival than those without. There was no significant difference between different T stages and N stages. In multivariate analysis (Table 3), only patients with distant metastasis showed significantly worse overall survival than others. In subgroup analysis, in patients with stage I-II anal cancer, there was no significant difference between these patients undergoing CCRT with or without operation (0.57 vs. 0.72, p = 0.206, Fig. 1A). No difference was found between these patients undergoing local excision with or without CCRT (0.89 vs. 0.67, p = 0.243, Fig. 1C). Worse overall survival for patients with stage III-IV disease treated with operation plus CCRT than with CCRT only (0.08 vs. 0.66, p ＜ 0.05). Conclusion. Early anal cancer can be treated with local excision or definite CCRT without significant difference. Surgery has no benefit but worse survival for patients with uncontrolled distant disease.

關鍵字

Anal cancer ； Oncologic outcome

並列摘要

介紹：大多數肛門癌患者推薦接受化放療。然而，一些患者可能仍會接受手術，以期改善腫瘤學結果。在這項研究中，我們分析了肛門癌患者接受不同治療的腫瘤學結果並回顧了文獻。方法：我們收集肛門癌患者及其變量並執行單變量和多變量分析。所有患者根據治療類型分為三組：僅手術組、僅化放療組和手術加上化放療組。結果：在單變量分析中，鱗狀細胞癌患者的存活率優於腺癌。遠處轉移患者的存活率明顯低於無遠處轉移患者。不同的T stage和N stage之間沒有顯著差異。結論：早期肛門癌可採用局部切除或化放療，結果無顯著差異。對於有轉移的患者，手術沒有好處，會使存活率率更差。

並列關鍵字

肛門癌 ； 存活分析