Abstracts
2002 Digestive Disease Week

# 101199 Abstract ID: 101199 Surgical Treatment of Anorectal Sarcoma
Ravinder K Annamaneni, Takamori Nakayama, Nicole M Lanouette, Jose G Guillem, James M Woodruff, Leah Ben-Porat, Bruce D Minsky, Douglas W Wong, Alfred M Cohen, Murray F Brennan, Phillip B Paty, New York, NY

Introduction Optimal surgical treatment for sarcomas arising in the anus or rectum is not well established. We have reviewed our institutional experience to compare initial treatment by transanal local excision (LocE) or by radical excision (RadE). Methods 38 patients (M: F 24:14) with primary anorectal sarcoma (leiomyosarcoma and gastrointestinal stromal tumor) were treated by complete excision between 1974-2001.Data were retrieved from a prospective clinical database, chart review, and review of pathology slides. Statistical analysis included Fisher's Exact test, Kaplan-Meier method, and log-rank test. Results 34 tumors arose in the rectum and 4 in the anal canal. 17 were treated by transanal excision, 21 by radical excision (14 APR, 4 LAR, 3 TPA). 19 patients received adjuvant radiation (external beam 6,brachytherapy 10, both 3) and 7 patients had adjuvant chemotherapy. Patients were followed to death or for median of 5.92 years (DOD 19, NED 12, AWD 5, DOC 2). See table for summary. Conclusion Cure of anorectal sarcoma is uncommon. Surgical treatment should be selected to achieve best palliation. Compared to radical surgery patients, those selected for local excision +/- radiation have more favorable tumors, better survival, and have less longterm risk of colostomy. Local excision is an acceptable treatment option for selected patients.