Pintor M P, Northover J M, Nicholls R J
St. Mark's Hospital for Diseases of the Colon and Rectum, London, UK.
Br J Surg. 1989 Aug;76(8):806-10. doi: 10.1002/bjs.1800760814.
Two hundred and twenty-eight patients with anal carcinoma treated between 1948 and 1984 were reviewed. Of 145 with anal canal carcinoma, 118 were treated by total anorectal excision, nine by local excision and 13 by radiotherapy. Fifteen patients were inoperable. There were five postoperative deaths. Crude and cancer-specific survival rates of 123 patients treated 5 or more years previously were 58 and 64 per cent. These rates for patients undergoing total anorectal excision were 62 and 65 per cent, and local excision 87 and 100 per cent. Eighty-three patients had carcinoma of the anal margin. Of these, 55 were treated by local excision, 18 by total anorectal excision and 20 by radiotherapy. Eight patients were inoperable. Crude and cancer-specific survival rates for 72 patients followed for 5 years were 55 and 57 per cent with respective rates of 65 and 69 per cent after local excision and 36 and 40 per cent after total anorectal excision. The 5-year survival rate of 27 patients with TNM N1 stage was 48 per cent. Histological confirmation was obtained in only nine of these patients, however, but five (55 per cent) survived 5 years after block dissection or radiotherapy. Metachronous lymphadenopathy occurred in 25 patients. The 5-year survival rate in the 23 cases that were histologically confirmed was 35 per cent after block dissection (17 cases) and radiotherapy (four cases). Using a modification of Papillon's T classification for anal canal carcinoma, stage correlated with survival after combining T1 with T2 tumours and T2 with T3 tumours. Five-year survival rates in these groups were 60 and 54 per cent respectively. The TN M-UICC classification for anal margin carcinoma correlated with survival in a similar manner. The 5-year survival rate was 65 per cent for patients with T1 and T2 tumours and 33 per cent for those with T3 and T4 tumours.
回顾了1948年至1984年间接受治疗的228例肛管癌患者。在145例肛管癌患者中，118例行全肛管直肠切除术，9例行局部切除术，13例行放射治疗。15例患者无法手术。有5例术后死亡。123例5年或更久之前接受治疗的患者的粗生存率和癌症特异性生存率分别为58%和64%。接受全肛管直肠切除术患者的这些生存率分别为62%和65%，局部切除术患者分别为87%和100%。83例患者为肛缘癌。其中，55例行局部切除术，18例行全肛管直肠切除术，20例行放射治疗。8例患者无法手术。72例随访5年的患者的粗生存率和癌症特异性生存率分别为55%和57%，局部切除术后分别为65%和69%，全肛管直肠切除术后分别为36%和40%。27例TNM N1期患者的5年生存率为48%。然而，这些患者中只有9例获得了组织学确诊，但5例（55%）在淋巴结清扫术或放射治疗后存活了5年。25例患者发生异时性淋巴结病。23例经组织学确诊的病例在淋巴结清扫术（17例）和放射治疗（4例）后的5年生存率为35%。对肛管癌采用改良的Papillon T分类法，将T1与T2肿瘤合并、T2与T3肿瘤合并后，分期与生存率相关。这些组的5年生存率分别为60%和54%。肛缘癌的TNM-UICC分类与生存率的相关性与此类似。T1和T2肿瘤患者的5年生存率为65%，T3和T4肿瘤患者为33%。
