Ciência e terapia do câncer

A Retrospective Epidemiological Study and Prognostic Factors of Lower Rectal and Anal Carcinoma

Abstract

Sara Mahmoud Srour El-Zayat, Hanem Abd-Elfatah Sakr, Mona Magdy Halim and Hend M. Hamdey Rashed Elkalla

Background: Anorectal carcinoma includes tumors of the anal margin, the anal canal, and the low rectum. The incidence of rectal cancer is 40% of all colorectal cancers, but anal tumors represent 2.5% of all gastrointestinal tumors. The incidence of anal malignancy has been increased in the last 30 years, both in the USA and elsewhere. Adenocarcinomas are the most frequent pathological subtype.

Patients and methods: Our study is retrospective and was conducted for 5 years. Patient’s data were collected from the medical records through a predesigned sheet that included the following information: demographic data, medical history, past history, presenting symptoms, pathological data, treatment details and treatments outcomes in the form of PFS and OS.

Results: Of 181 cases, 11.6% were anal adenocarcinoma, 39.2% were rectal adenocarcinoma, 74% were anorectal adenocarcinoma, and 2.2% were anal squamous cell carcinoma. The median age for AA was 55 years, 52 years for RA, and 51 years for ARA. The median OS was lower for AA (41 months); compared with RA (62.3 months) and ARA (61.1 months) (P value 0.3) that needs further evaluation. Early stages had a better OS (63 months) while advanced and metastatic stages were associated with shorter OS (30.2 and 12.4months) respectively with highly statistically significant. Positive safety margin and positive lymphovascular/perineural invasion were associated with shorter OS (31.9 months) in comparison to higher survival in patients with the negativity of these two factors (61.6 months) and this was significantly high (p-value: 0.03). Univariate analysis for PFS revealed that the age only can affect PFS significantly as the younger age group has a median survival of 54 months in comparison to 33.5 months for the older age.

Conclusion: AA has poor prognosis than ARA, RA. The early-stage has a better OS that needs more effort for early diagnosis and treatment.