Primary adenocarcinoma of the anus: A retrospective analysis

Purpose: To report the clinical features and outcome of patients with prima ry adenocarcinoma of the anus following radiotherapy with or without chemot herapy, Methods and Materials: A retrospective analysis was performed on 15 patient s referred to Peter MacCallum Cancer Institute between 1981 to 1998 with pr imary adenocarcinoma of the anus. The median follow-up was 7.5 years. Six p atients underwent treatment with curative intent-either chemoradiation or r adiotherapy alone. Surgery,vas mainly limited to either incisional or excis ional biopsy. The remaining nine patients were treated with palliative inte nt because of advanced age; advanced disease, or poor medical status. The b iological equivalent doses were calculated for all patients and correlated with time to progression. Results: None of the curative group had relapsed after a median follow-up o f 6.6 years. All except one were alive and well, No patient developed any s erious long-term toxicity and all patients avoided colostomy, All patients managed with palliative intent died with persistent locoregional disease wi th a median survival of 0.8 year, Conclusion: Primary adenocarcinoma of the anus is a very rare disease that precludes a rigorous analysis, This study demonstrates that radiation and i n particular chemoradiation are effective therapies consistent with other r ecent series and analogous to squamous cell carcinomas of the anus, It also emphasizes the poor prognosis of patients treated with palliative intent. (C) 1999 Elsevier Science Inc.