Multimodal Therapy of Squamous Cell Carcinoma of the Anus With Distant Metastasis: A Single-Institution Experience

Evesque, Ludovic; Bénézery, Karen; Follana, Philippe; Falk, Alexander Tuan; Doyen, J.; Reure, Juliette; Cavaglione, Gérard; François, Ετιεννε

doi:10.1097/dcr.0000000000000827

Cited by 26 publications

(17 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is not surprising then that multimodality treatment strategies are increasingly adopted in routine clinical practice and reported in retrospective series (Table ). In the study by Evesque et al ( n = 50), 60% of advanced anal SCC patients received surgery, radiotherapy or RFA, and their outcome was significantly better than that of patients treated with systemic therapy alone (median OS 22.0 vs 13.0 months; P = 0.002). At 2 years, 40% and 20% of patients in the respective groups were still alive.…”

Section: Discussionmentioning

confidence: 96%

“…The rarity of advanced anal SCC represents an obvious obstacle to assessing the role of a similarly aggressive treatment approach in this disease setting. Nevertheless, multimodality therapies have been increasingly used in these patients as reported in recent retrospective studies, suggesting that there are growing expectations from physicians that combining systemic chemotherapy with organ‐directed treatments may provide an incremental survival advantage over systemic chemotherapy alone, at least in carefully selected patients with oligometastatic disease …”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, multimodality therapies have been increasingly used in these patients as reported in recent retrospective studies, suggesting that there are growing expectations from physicians that combining systemic chemotherapy with organ-directed treatments may provide an incremental survival advantage over systemic chemotherapy alone, at least in carefully selected patients with oligometastatic disease. 16,17,[21][22][23] In this case series, we report the outcome of advanced anal SCC patients who were treated with organ-directed therapies with a curative intent at two cancer centers in the UK and Australia.…”

mentioning

confidence: 99%

“…16,17,30 It is not surprising then that multimodality treatment strategies are increasingly adopted in routine clinical practice and reported in retrospective series ( Table 2). In the study by Evesque et al 23 22 Finally, in the recent Epitopes-HPV02 phase II trial, 21% of patients were treated with multidisciplinary therapies after systemic chemotherapy and the majority of these were progression free at the last follow-up. 15 It is clear that, in view of the retrospective design, small sample size, and heterogeneity of both patients and treatment approaches, the currently available studies cannot provide the level of evidence that is necessary to build robust recommendations regarding the role of organ-directed treatments in the management of advanced anal SCC.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Multimodality treatment of oligometastatic anal squamous cell carcinoma: A case series and literature review

Sclafani

Hesselberg

Thompson

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives There is limited evidence to guide the management of patients with oligometastatic anal squamous cell carcinoma (SCC). We aimed to address this question by reporting the outcome of SCC patients who were treated with organ‐directed therapies at two large cancer centers. Methods Patients with advanced anal SCC who were treated with surgery, stereotactic radiotherapy, or radiofrequency ablation (RFA) with a curative intent from 2008 to 2017 were retrospectively identified from the institutional electronic patient records. Results Eight patients with liver or lung metastases met the study inclusion criteria. Seven were treated with surgery while one received RFA and radiotherapy. Median progression‐free survival was 5 months (range, 4‐39). Three patients underwent repeat organ‐directed treatment upon failure of the initial surgery with no evidence of further recurrent disease at the last follow‐up. Median overall survival from the time of the first organ‐directed therapy was 31 months (range, 11‐96) with two out of eight patients being alive and disease‐free at 5 years. Conclusions Our study confirms that consideration should be given to the adoption of a multidisciplinary treatment approach in carefully selected, oligometastatic anal SCC patients as organ‐directed therapies may offer the chance of achieving a relatively long disease control.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Multimodality treatment of oligometastatic anal squamous cell carcinoma: A case series and literature review

Sclafani

Hesselberg

Thompson

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Oligometastatic disease is a particular presentation of anal SCC, and recent literature has demonstrated that organ-directed therapies in carefully selected patients may offer long-term disease control [12,13]. A multidisciplinary approach, including surgery, should be considered for eligible patients.…”

Section: Discussionmentioning

confidence: 99%

A rare case of recurrent epidermoid anal cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy—case report

et al. 2020

View full text Add to dashboard Cite

Background: Anal cancer is a rare cancer with chemoradiation being the mainstay of treatment for locoregional presentation. In North America, the most common subtype is anal squamous cell carcinoma (epidermoid). A surgical approach is considered for persistent or recurrent anal disease and systemic chemotherapy for metastatic disease. We are presenting a unique case of recurrent anal cancer with isolated peritoneal malignancy, an oligometastatic state which is rare in itself. It was treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. There are currently no clear guidelines for the aforementioned presentation. The discussion drew on the feasibility and safety of this approach. Case presentation: A 68-year-old woman diagnosed with an epidermoid anal cancer (stage 3B) was initially treated with chemoradiation therapy (Standard Nigro Protocol) in 2014. At the 5-year mark post-treatment, she was diagnosed with a recurrent anal epidermoid cancer in the form of isolated peritoneal carcinomatosis proven by biopsy. After declining systemic chemotherapy, she underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with Mitomycin-C©. Peritoneal carcinomatosis index was evaluated at 10, and intraoperative frozen sections were positive for carcinoma of epidermoid origin compatible with anal cancer. A completeness of cytoreduction score of 0 was achieved during the cytoreductive surgery, and her hospital course was unremarkable. She remains disease-free 12 months later. Conclusions: To our knowledge, this is the first case reporting the disease presentation of anal cancer with oligometastatic dissemination to the peritoneum. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were performed. Thus far, this approach seems to be a safe and feasible option for short-term control of the disease.

show abstract

Neoplasms of the Anus

Jácome

Eng

2022

Holland‐Frei Cancer Medicine

View full text Add to dashboard Cite

Overview Squamous cell carcinoma of the anal canal (SCCA) is a rare human papillomavirus (HPV)‐related malignancy, but with rising incidence in the last decade. Chemoradiotherapy (CRT) remains the cornerstone of the treatment of non‐metastatic disease, characterized by remarkable response rates of 90% and 5‐year overall survival (OS) of 80%. Nevertheless, despite the high efficacy observed with combined modality treatment, almost half of the patients with locally advanced disease have high‐risk features (T3, T4, or node‐positive disease) for treatment failure. The management of unresectable recurrences or metastatic disease is an unmet clinical need, marked by poor clinical outcomes. Immune checkpoint inhibitors and immunotherapeutic approaches have been demonstrating promising results in the management of advanced disease in the past few years, but big steps forward will only be taken when the underutilized HPV vaccination becomes more widely accepted for use.

show abstract

Multimodal Therapy of Squamous Cell Carcinoma of the Anus With Distant Metastasis: A Single-Institution Experience

Cited by 26 publications

References 18 publications

Multimodality treatment of oligometastatic anal squamous cell carcinoma: A case series and literature review

Multimodality treatment of oligometastatic anal squamous cell carcinoma: A case series and literature review

A rare case of recurrent epidermoid anal cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy—case report

Neoplasms of the Anus

Contact Info

Product

Resources

About