Title | Fistula-associated anal adenocarcinoma: good results with aggressive therapy. |
Publication Type | Journal Article |
Year of Publication | 2008 |
Authors | Gaertner WB, Hagerman GF, Finne CO, Alavi K, Jessurun J, Rothenberger DA, Madoff RD |
Journal | Dis Colon Rectum |
Volume | 51 |
Issue | 7 |
Pagination | 1061-7 |
Date Published | 2008 Jul |
ISSN | 1530-0358 |
Keywords | Adenocarcinoma, Adult, Aged, Biopsy, Digestive System Surgical Procedures, Drainage, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Rectal Fistula, Rectal Neoplasms, Retrospective Studies, Time Factors, Treatment Outcome, Urogenital Surgical Procedures |
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. |
DOI | 10.1007/s10350-008-9294-4 |
Alternate Journal | Dis Colon Rectum |
PubMed ID | 18418652 |
Related Faculty:
Jose Jessurun, M.D.