Clinicopathologic Features and Outcome of Adenocarcinoma of the Anal Canal: A Population-Based Study.

Shekhar Gogna,Rifat Latifi,David Samson,Aram Rojas,Agon Kajmolli,Xiang Da Dong,Roberto Bergamaschi,Mahir Gachabayov

doi:10.1155/2020/5139236

Shekhar Gogna, Rifat Latifi + Show 6 more

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https://doi.org/10.1155/2020/5139236

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Abstract

Background Anal canal adenocarcinoma (AA) is an uncommon tumor of the gastrointestinal tract. We seek to provide a detailed description of the incidence, demographics, and outcome of this rare tumor in the United States. Methods The data on anal canal adenocarcinoma from SEER Program, between 1973–2015, were extracted. We analyzed the incidence rates by demographics and tumor characteristics, followed by analysis of its impact on survival. Results The incidence of AA increased initially by 4.03% yearly from 1973 to 1985 but had a modest decline of 0.32% annually thereafter. The mean age for diagnosis of AA was 68.12 ± 14.02 years. Males outnumbered females by 54.8 to 45.2%. Tumors were mostly localized on presentation (44.4%) and moderately differentiated (41.1%). Age generally correlated with poor overall cancer survival. However, young patients (age <40 years) also showed poor long-term survival. Patients with localized disease and well-differentiated tumors showed better survival outcomes. Surgical intervention improved survival significantly as compared to patients who did not (116.7 months vs 42.7 months, p < 0.01). Conclusions Anal canal adenocarcinoma demonstrated a poor bimodal cancer-free survival in both younger and older patient groups. Surgery significantly improves odds of survival and should be offered to patients amenable to intervention.

Highlights

Adenocarcinoma of the anal canal is a rare neoplasm
The incidence is only a few thousand cases per year. It represents approximately 16.5% of all types of anal canal cancers, which is dominated by squamous cell carcinoma [1]. e anal canal extends from the anal margin to the anorectal ring/flexure representing the terminal part of the gastrointestinal tract
Several proposals have been made as to the pathologic mechanisms leading to the anal canal adenocarcinomas (AA). ese include anal glandular carcinomas originating from the anal glands, colloid carcinomas associated with Paget’s disease of the anus, and adenocarcinomas arising from chronic fistula and inflammatory epithelium in the anus, as well as adenocarcinomas that arose from the distal rectum with extension into the anal canal [3, 4]

Summary

Background

Anal canal adenocarcinoma (AA) is an uncommon tumor of the gastrointestinal tract. We seek to provide a detailed description of the incidence, demographics, and outcome of this rare tumor in the United States. We analyzed the incidence rates by demographics and tumor characteristics, followed by analysis of its impact on survival. Age generally correlated with poor overall cancer survival. Young patients (age

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