2020 Volume 73 Issue 6 Pages 227-236
Anal canal cancer with pagetoid spread is rare. A review of the literature found that very little research has been done on cases with this kind of condition. One study reported on a case with pagetoid spread but the findings were inconclusive and required further research. The aim of this study was to determine the clinicopathologic characteristics and treatment outcome for anal canal cancer with pagetoid spread. A retrospective review of cases (n = 81) in Japan found that the average age of the patients was 70.2 years, 97% had symptoms, 32% had difficulty with primary tumor identification, and cases with early-stage anal canal cancer, including intramucosal carcinoma, showed pagetoid spread. Immunohistochemistry was performed to differentiate between primary Paget's disease and pagetoid spread, and it was found that many cases were GCDFP-/CK20+/CK7+. Preoperative mapping biopsies to identify the areas for resection were performed on 46% of the patients, and rectal amputation was the result in many cases. The 5-year cumulative recurrence rate was 51.3% (inguinal lymph node and local recurrence) and the 5-year overall survival rate was 45.4%. In conclusion, anal canal cancer with pagetoid spread had a poorer prognosis than anal canal cancer without pagetoid spread.
