Anal Adenocarcinoma: Outcomes in an Uncommon Malignancy
Autor: | Jacquelyn Harrison, Herand Abcarian, Jose R. Cintron, Noelle Bertelson, Jennifer Blumetti, Vivek Chaudhry |
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Rok vydání: | 2015 |
Předmět: |
Male
medicine.medical_specialty Abdominoperineal resection business.industry Anal Adenocarcinoma medicine.medical_treatment Cancer Chemoradiotherapy Adjuvant General Medicine Adenocarcinoma Middle Aged Anal canal Anus Neoplasms medicine.disease Malignancy Surgery Treatment Outcome medicine.anatomical_structure medicine Humans Female Stage (cooking) business Neoadjuvant therapy |
Zdroj: | The American Surgeon. 81:1114-1117 |
ISSN: | 1555-9823 0003-1348 |
Popis: | Adenocarcinoma is an uncommon malignancy of the anal canal. Although it is recognized as an aggressive disease, optimal management and long-term outcomes are not well established. Patients diagnosed with anal adenocarcinoma were identified from a cancer database. Their charts were reviewed for patient and disease characteristics, management, and outcomes. Eighteen patient charts from 1997 to 2012 were reviewed. Nine patients presented with stage II disease, five with stage III, three with stage IV, and one was inadequately staged before chemoradiation. One patient refused treatment, one patient went straight to abdominoperineal resection, 13 patients underwent initial chemoradiation therapy, and three underwent palliative chemotherapy. Of the 13 patients who received neoadjuvant therapy, eight underwent subsequent radical resection; three progressed during neoadjuvant and became unresectable, one had complete pathologic response and was observed, and one did not complete neoadjuvant and was lost to follow-up. Two patients with stage II disease were disease free over eight years, and one was disease free after 26 months; four patients had persistent or recurrent local disease, and 10 developed metastatic disease. Seven patients died with disease at a median 16 months, and the other seven were alive with disease at a median follow-up of 10 months. Patients with anal adenocarcinoma present at advanced stages, and cure is rare. Although chemoradiation followed by abdominoperineal resection is the most common management strategy, the potential for curative resection and long-term disease free survival is minimal, regardless of stage at presentation. |
Databáze: | OpenAIRE |
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