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肛管边缘表皮样癌。病理特征、治疗及临床结果。

Epidermoid cancer of the anal margin. Pathologic features, treatment, and clinical results.

作者信息

Greenall M J, Quan S H, Stearns M W, Urmacher C, DeCosse J J

出版信息

Am J Surg. 1985 Jan;149(1):95-101. doi: 10.1016/s0002-9610(85)80016-7.

Abstract

Epidermoid cancer of the anal margin should be distinguished from that in the canal because of its different clinical and pathologic characteristics, the suitability of local excision for its treatment, and its better overall prognosis. In addition, margin cancer rarely metastasises to visceral sites. Forty-eight patients with epidermoid cancer of the anal margin were reviewed. Two refused treatment, 4 had palliative therapy for advanced, inoperable disease, 31 had local excision, and 11 were treated by abdominoperineal resection. Local excision provided satisfactory results with a corrected 5 year survival of 88 percent, although locoregional recurrence developed in 46 percent of these patients during follow-up. A second local excision or inguinal lymphadenectomy provided good results in the patients with recurrence. Abdominoperineal resection did not provide better overall survival figures.

摘要

肛管边缘的表皮样癌应与肛管内的表皮样癌相区分,因为它们具有不同的临床和病理特征、适合采用局部切除进行治疗,且总体预后较好。此外,边缘癌很少转移至内脏部位。对48例肛管边缘表皮样癌患者进行了回顾性研究。2例拒绝治疗,4例对晚期无法手术的疾病进行了姑息治疗,31例行局部切除,11例行腹会阴联合切除术。局部切除取得了满意的效果,校正后的5年生存率为88%,尽管在随访期间这些患者中有46%出现了局部区域复发。对于复发患者,再次局部切除或腹股沟淋巴结清扫术取得了良好效果。腹会阴联合切除术并未带来更好的总体生存数据。

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