Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
School of Cancer Sciences, University of Birmingham, Birmingham, UK.
Colorectal Dis. 2023 Jul;25(7):1403-1413. doi: 10.1111/codi.16562. Epub 2023 Apr 8.
Squamous cell carcinomas of the anus are normally treated with synchronous chemoradiotherapy (CRT). Small, localized anal margin tumours may be adequately treated by local excision (LE) alone. This study aims to investigate the outcomes of patients with anal margin tumours treated with LE alone, reserving the use of CRT for salvage on local recurrence (LR).
Patients with small, localized (stage I/IIA) anal margin tumours treated by LE from October 1999 to September 2018 were identified. The effect of tumour size and resection margin on LR risk was analysed. Outcomes of overall survival and disease-free survival were measured.
Fifty-five patients with anal margin tumours were identified. Overall 5-year LR, overall survival and disease-free survival rates were 8%, 86% and 82% respectively. Of the seven LRs, five were successfully salvaged with CRT with no further recurrence and two were not fit for CRT. Resection margins in non-fragmented tumours and tumour size did not significantly influence LR risk.
Most small, localized anal margin tumours can be adequately treated by LE alone with low LR rates. Most patients who developed LR were salvaged using CRT, with no cancer-related deaths reported.
肛门鳞状细胞癌通常采用同步放化疗（CRT）治疗。对于小的局限性肛门边缘肿瘤，单独局部切除（LE）可能足以治疗。本研究旨在探讨单独采用 LE 治疗肛门边缘肿瘤患者的结局，仅在局部复发（LR）时保留 CRT 作为挽救治疗。
回顾性分析 1999 年 10 月至 2018 年 9 月采用 LE 治疗的小的局限性（Ⅰ/ⅡA 期）肛门边缘肿瘤患者。分析肿瘤大小和切缘对 LR 风险的影响。测量总生存率和无病生存率。
共 55 例肛门边缘肿瘤患者。总的 5 年 LR、总生存率和无病生存率分别为 8%、86%和 82%。7 例 LR 中，5 例经 CRT 成功挽救治疗，无进一步复发，2 例不适合 CRT。非碎裂肿瘤的切缘和肿瘤大小均未显著影响 LR 风险。
大多数小的局限性肛门边缘肿瘤可以单独采用 LE 充分治疗，LR 发生率低。大多数发生 LR 的患者采用 CRT 挽救治疗，无癌症相关死亡。
