Gamstätter G, Kurock W, Seitz W
Leber Magen Darm. 1977 Apr;7(2):123-9.
Case reports are given of 37 patients treated between 1964 and 1976 because of carcinoma of the anus, and clinical signs and symptoms, therapy and prognosis are discussed. Most of the patients were 50-70 years old, women being more often afficted then men. Often the carcinoma was misdiagnosed as a benign disease. Hemorrhage and pain were the presenting symptoms in most of the case. Therapy depends upon the localization and the stage of the tumor. Carcinoma localizad distally of the linea dentata were excised locally; infiltrating carcinomas received radiotherapy postoperatively. Abdominal amputation of the rectum was performed if the linea dentata or regional lymph-nodes were involved. Bilateral dissection of inguinal lymph-nodes was performed only if inguinal metastases were suspected. No patients surviving 5 years were observed in the group with lymph-node metastases. On the contrary all patients survived, if carcinoma was localized distally to the linea dentata and had been excised locally. Recurrent malignancy was found only in 3 of these cases. On the basis of these findings it can be concluded that local excision is the therapy of choice in selected cases.
本文报告了1964年至1976年间因肛门癌接受治疗的37例患者的病例，并对其临床体征、症状、治疗方法及预后进行了讨论。大多数患者年龄在50至70岁之间，女性患者比男性更为常见。该癌症常被误诊为良性疾病。大多数病例的首发症状为出血和疼痛。治疗方法取决于肿瘤的位置和分期。齿状线远端的癌肿行局部切除；浸润性癌术后接受放疗。若齿状线或区域淋巴结受累，则行直肠腹部切除术。仅在怀疑有腹股沟转移时才进行双侧腹股沟淋巴结清扫。有淋巴结转移的患者组中未观察到存活5年的患者。相反，若癌肿位于齿状线远端并已行局部切除，则所有患者均存活。这些病例中仅3例发现复发性恶性肿瘤。基于这些发现，可以得出结论，在某些选定的病例中，局部切除是首选的治疗方法。
