Carcinoma Associated with Anal Fistula; A Clinicopathologics Study of 7 Patients

Rumiko Tashima, Sachio Yokoyama, Nobuyuki Arima*, Kenichirou Baba and Masakazu Matsuda

Department of Surgery and Department of Pathology*, Kumamoto City Hospital

We analyzed the clinicopathologic features and treatment outcome of 7 patients with carcinoma associated with anal fistula (CAF) from 1989 to 2005 in our hospital. The male to female ratio was 5:2, and the mean age 67 years (48-82). The average number of years of CAF arising from anal fistula was 26.4 years. Perianal pain was present in all patients. The mean tumor diameter was 55 mm. Histologically, 71% of patients had mucinous adenocarcinoma and 86% stage II/III. Half of stage II/III disease had invaded adjacent viscera. All patients underwent abdominoperineal resection, and three underwent postoperative radiation and/or chemotherapy. Local recurrence developed in 4 and distant metastasis in 3. The four with local recurrence died, surviving a mean 2.3 years. Two patients have remained disease free for 56 to 61 months. Early diagnosis and aggressive excision with clear margins are required for cure. Chemoradiation followed by surgery may improve outcome of the disease invading to adjacent viscera.

Key words
carcinoma associated with anal fistula, chemotherapy, radiation

Reprint requests
Rumiko Tashima Department of Surgery, Kumamoto Central Hospital
1-5-1 Tainoshima, Kumamoto, 862-0965 JAPAN

Accepted
October 29, 2007

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