| Autor: |
Gaertner, Wolfgang, Hagerman, Gonzalo, Finne, Charles, Alavi, Karim, Jessurun, Jose, Rothenberger, David, Madoff, Robert |
| Zdroj: |
Diseases of the Colon & Rectum; 20240101, Issue: Preprints p1-7, 7p |
| Abstrakt: |
Abstract: Purpose: To evaluate the clinical features, pathology, treatment, and outcome of patients with fistula-associated anal adenocarcinoma. Methods: We identified 14 patients with histologically proven fistula-associated anal adenocarcinoma. We reviewed their medical records and pathology specimens to characterize their presentation, treatment, and clinical outcome. Results: Nine patients presented with a persistent fistula, 3 with a perianal mass, 1 with pain and drainage, and 1 with a recurrent perianal abscess. The average age at time of diagnosis was 59 (range, 37–76) years. Eleven patients had preexisting chronic anal fistulas. Ten had Crohn’s disease, and 1 had previously received pelvic radiation therapy. The diagnosis of cancer was suspected during physical examination in 6 of the 14 patients (43 percent). Twelve patients had extensive local disease at presentation. Primary abdominoperineal resection was performed in 11 patients, 7 following neoadjuvant chemoradiation. Six patients received postoperative chemotherapy, and 2 received postoperative radiation. Four patients died with metastatic disease. The remaining 10 patients are alive without evidence of disease at a mean follow-up of 64.3 (range, 14–149) months. Conclusions: The diagnosis of fistula-associated anal adenocarcinoma is often unsuspected. Most patients can be cured with aggressive surgical and adjuvant chemoradiotherapy. |
| Databáze: |
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