Sun Peng, Li Yu-Hong, Wang Wei, Chen Chuang-Qi, Wang Ling-Yun
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
J BUON. 2014 Jan-Mar;19(1):103-8.
Malignancies of the anal canal are rare diseases associated with limited reports and insufficient data. The purpose of this study was to evaluate the spectrum of pathological subtypes, therapeutic modalities and prognosis of patients in the Chinese population with anal canal malignancies.
A retrospective consecutive series of patients with malignancies of the anal canal at 4 institutions in China between January 1990 and December 2011 was studied. The patient demographic data, including age, gender, tumor stage, initial symptoms, pathological diagnosis, treatment and survival, were collected and analyzed from the hospitals' databases.
A total of 180 patients (90 males, 90 females) with anal canal malignancies was identified. Their median age was 58 years (range 17-88). The 3 most common pathological subtypes were adenocarcinoma (N-129, 71.7%), squamous cell carcinoma (SCC; N=21, 11.7%) and melanoma (N7equals;15, 8.3%). Ninety-five adenocarcinoma patients and 10 SCC patients were managed with abdominoperineal resection (APR). With a median follow-up time of 28.9 months (range 1-173), the 5-year overall survival (OS) rates for all patients, adenocarcinoma patients, SCC patients and melanoma patients were 41.9, 40.6, 44.5 and 14.8% respectively, and the median OS time were 46.8, 50.1, 52.5 and 25.0 months, respectively (p=0.173).
Adenocarcinoma was the major histological subtype in Chinese patients with anal canal malignancies. APR-based combined modality treatment was the first choice for the past two decades, whereas multidisciplinary treatment was not performed adequately. The management of SCC must be standardized in South China population. In the future, randomized clinical trials are warranted for the optimal treatment options of anal canal adenocarcinoma patients.
肛管恶性肿瘤是罕见疾病，相关报道有限且数据不足。本研究旨在评估中国人群肛管恶性肿瘤患者的病理亚型谱、治疗方式及预后。
对1990年1月至2011年12月期间中国4家机构连续收治的肛管恶性肿瘤患者进行回顾性研究。从医院数据库收集并分析患者的人口统计学数据，包括年龄、性别、肿瘤分期、初始症状、病理诊断、治疗及生存情况。
共确定180例肛管恶性肿瘤患者（男性90例，女性90例）。他们的中位年龄为58岁（范围17 - 88岁）。3种最常见的病理亚型为腺癌（N = 129，71.7%）、鳞状细胞癌（SCC；N = 21，11.7%）和黑色素瘤（N = 15，8.3%）。95例腺癌患者和10例SCC患者接受了腹会阴联合切除术（APR）。中位随访时间为28.9个月（范围1 - 173个月），所有患者、腺癌患者、SCC患者和黑色素瘤患者的5年总生存率（OS）分别为41.9%、40.6%、44.5%和14.8%，中位OS时间分别为46.8个月、50.1个月、52.5个月和25.0个月（p = 0.173）。
腺癌是中国肛管恶性肿瘤患者的主要组织学亚型。在过去二十年中，以APR为基础的综合治疗是首选，但多学科治疗未得到充分实施。华南人群中SCC的治疗必须标准化。未来，有必要进行随机临床试验以确定肛管腺癌患者的最佳治疗方案。
