Clark J, Petrelli N, Herrera L, Mittelman A
Cancer. 1986 Jan 15;57(2):400-6. doi: 10.1002/1097-0142(19860115)57:2<400::aid-cncr2820570237>3.0.co;2-t.
The charts of 67 patients treated for epidermoid carcinoma of the surgical anal canal were reviewed. The clinical presentation, type of surgical procedure performed, lymph node status of the pararectal and inguinal nodes, time of recurrence, site of recurrence, and median survival from the date of primary surgery and from the date of recurrence were determined. There were 55 patients (82%) who had a minimum of 5 years' follow-up since initial treatment. Optimal surgical treatment requires an abdominoperineal resection with wide dissection of the ischiorectal fossa and perineum in all patients, as well as an en bloc excision of the posterior vaginal wall in women. Although excision of the posterior vaginal wall improves the disease-free interval, median survival is not altered, compared with the group without vaginectomy. The predominant sites of local recurrence in men are the pelvis and perineum, and in women, the pelvis and posterior vaginal wall. The status of the pararectal lymph nodes from the operative specimen can give accurate information about the relative risk of recurrence. The presence of inguinal lymph node metastases represents a poor prognosis because of a close association with systemic metastases.
对67例接受手术治疗的肛管表皮样癌患者的病历进行了回顾。确定了临床表现、所施行的手术类型、直肠旁和腹股沟淋巴结的状态、复发时间、复发部位以及自初次手术之日和复发之日起的中位生存期。有55例患者（82%）自初始治疗后至少随访了5年。所有患者的最佳手术治疗需要进行腹会阴切除术，并广泛清扫坐骨直肠窝和会阴，对于女性患者还需整块切除阴道后壁。虽然切除阴道后壁可改善无病生存期，但与未行阴道切除术的组相比，中位生存期并无改变。男性局部复发的主要部位是骨盆和会阴，女性则是骨盆和阴道后壁。手术标本中直肠旁淋巴结的状态可提供有关复发相对风险的准确信息。腹股沟淋巴结转移的存在预示着预后不良，因为其与全身转移密切相关。
