J Cancer 2017; 8(6):1097-1102. doi:10.7150/jca.17513 This issue

Research Paper

Anal adenocarcinoma requires prophylactic inguinal nodal treatment: Results from a single Chinese institution

Zhen Su1*, Zhan-Wen Guo2*, Yan-Ping Mao1*, Jie Tang1, Xiao-Wen Lan1, Fang-Yun Xie1✉, Qun Li1✉

1. Department of Radiation Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;
2. Department of Radiation Oncology, The General Hospital of Shenyang Military Area Command, No.83, Wenhua Road, Shenhe District, Shenyang, Liaoning province, 110016, China.
* These authors contributed equally to this work.

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Su Z, Guo ZW, Mao YP, Tang J, Lan XW, Xie FY, Li Q. Anal adenocarcinoma requires prophylactic inguinal nodal treatment: Results from a single Chinese institution. J Cancer 2017; 8(6):1097-1102. doi:10.7150/jca.17513. Available from https://www.jcancer.org/v08p1097.htm

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Background: Literature pertaining to prophylactic inguinal nodal treatment for anal adenocarcinoma in China is scarce.

Methods: In this retrospective study, we analyzed 126 patients from 1965 to 2015. Among these, 67 patients received surgery only, 18 patients received chemoradiotherapy only, 27 patients received a combination of both, and the remaining 14 patients received palliative treatment.

Results: The median follow up period was 30 months. The 1-year, 3-year, and 5-year overall survival rates were 85.8%, 62.5%, and 43.4%, respectively. The 5-year overall survival was 46.9% for patients with negative inguinal lymph nodes and 19.1% for patients with positive inguinal lymph nodes (p=0.007). The overall 5-year inguinal node relapse-free survival was 83.0%. The 5-year inguinal node relapse-free survival was 87.5% for stage I, 86.9% for stage II, and 76.5% for stage III cancers. Among those with negative inguinal nodes, the 5-year inguinal node relapse-free survival was 85.7% for negative regional lymph nodes and 75.4% for positive regional lymph nodes (p=0.089).

Conclusion: Inguinal lymph node is a high-risk subclinical area. Prophylactic inguinal nodal treatment is necessary for patients with anal adenocarcinoma irrespective of positive or negative inguinal lymph nodes.

Keywords: Anal adenocarcinoma, inguinal lymph node, prophylactic inguinal nodal treatment, overall survival, inguinal node relapse-free survival.