Anal cancer: Current standards in care and recent changes in practice

Shridhar, Ravi; Shibata, David; Chan, Emily; Thomas, Charles R.

doi:10.3322/caac.21259

Cited by 90 publications

(58 citation statements)

References 180 publications

(353 reference statements)

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“…[2] Knowing that anal cancer is caused by HPV in a similar way to cervical disease is helpful, but there is a lack of data guiding anal cancer screening recommendations. Most experts recommend anal screening for HIV+ men and women as well as men who have sex with men [3], and the American Cancer Society suggests that those at increased risk of anal intraepithelial neoplasia (AIN) may benefit from screening, including women who have had cervical or vulvar cancer [4]. A recent study by Slama, et al examined 172 high-risk women with cervical intraepithelial neoplasia 2 or greater (CIN2+) compared to 100 women with non-neoplastic gynecologic disease [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of anal cytology and dysplasia in women with a history of lower genital tract dysplasia and malignancy

Cronin

Bregar

Luis

et al. 2016

Gynecologic Oncology

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Objective To compare the prevalence of abnormal anal cytology, high-risk anal HPV and biopsy proven anal dysplasia among women with a history of lower genital tract malignancy compared to those with dysplasia. Methods A prospective cohort study was performed from December 2012 to February 2014 at outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal dysplasia, or malignancy were recruited. Anal cytology and HPV genotyping were performed. All women with abnormal anal cytology were referred for high-resolution anoscopy and biopsy. Results Sixty-seven women had a lower genital tract malignancy and 123 had a history of genital dysplasia. Average age in the malignancy group was 52.6 years (range 27–86) versus 43.5 years (range 21–81) in the dysplasia group (p<0.0002). Similar rates of anal dysplasia were seen in both groups, 12.99% (10 cases) in the malignancy group, versus 12.20% (15) in the dysplasia group (p=1.0). Six women in the malignancy group had anal intraepithelial neoplasia (AIN2+) compared to 2 in the dysplasia group (p= 0.03). Conclusions We found high rates of abnormal anal cytology and HPV in women with lower genital tract dysplasia and malignancy. We also found high rates of anal dysplasia in both groups with a trend towards increased rate in those women with history of genital malignancy. Since precancerous anal lesions are detectable and treatable, anal cancer screening may be potentially useful in both of these higher risk groups.

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Section: Introductionmentioning

confidence: 99%

Evaluation of anal cytology and dysplasia in women with a history of lower genital tract dysplasia and malignancy

Cronin

Bregar

Luis

et al. 2016

Gynecologic Oncology

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“…Hannes et al [27] confirmed a good 5-year survival rate of 86% in patients who underwent salvage surgery, with a longer survival of T0/T1 stage, than compared to patients presenting with T2/T3/T4 tumors. A recent review of literature confirmed the good survival rate of patients with recurrence disease after CRT, which showed the negative resection margin (R0) as the most significant prognostic factor [28] . In our study, the overall survival rates at 1, 3, and 5 years were 75, 60, and 37.4%, with disease-free survival rates of 67, 53, and 35%, respectively.…”

Section: Oncological Results Of Surgical Salvage Surgerymentioning

confidence: 91%

Results of Surgical Salvage Treatment for Anal Canal Cancer: A Retrospective Analysis with Overview of the Literature

et al. 2017

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Background and Aim: Chemoradiotherapy (CRT) is the gold standard treatment for anal cancer, which permits the maintenance of the anal function. However, about 30-40% of patients develop local disease progression, for which surgery represents a good salvage therapy. The aim of this study is to evaluate survival and morbidity rate in patients who undergo salvage surgery in our single institution, with an overview of the literature. Methods: A retrospective study was carried out on patients who underwent surgical treatment of anal canal cancer after failure of CRT. We evaluated overall survival at 1, 3, and 5 years and postoperative morbidity rate. Results: Twenty patients who underwent radical surgery with abdominoperineal resection were included in the study. The survival rates at 1, 3, and 5 years were 75, 60, and 37.4%; with a disease-free survival of 67, 53, and 35%, respectively. There was no postoperative mortality. The morbidity rate was 35%. Conclusion: Surgery represents the recommended therapy for persistent or recurrent anal canal cancer after CRT, with a good survival rate and an acceptable morbidity.

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“…The primary aim of treatment is to achieve cure with locoregional control and preservation of anal function [3,4] . Chemoradiation remains the standard of care leading to complete tumor regression in 80-90% of patients [3,14] .…”

Section: Discussionmentioning

confidence: 99%

“…SCCA is underrecognized due to the perceived rarity of the disease and because the inspection of the anal and perianal region is frequently neglected [14] . The diagnosis is delayed, not only due to medical misdiagnosis but also because in the beginning of symptoms patients defer medical attention and refuse observation (patient 3).…”

Section: Discussionmentioning

confidence: 99%

A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure

Barbeiro¹,

Atalaia-Martins²,

Marcos³

et al. 2016

GE Port J Gastroenterol

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Chronic anal fissure is a linear ulcer in the anal canal that has not cicatrized for more than 8-12 weeks of treatment. Most anal fissures are idiopathic and are located in the posterior midline. Squamous cell carcinoma of the anus commonly presents as bleeding and anal pain. It may also present as a mass, nonhealing ulcer, itching, discharge, fecal incontinence and fistulae. Not uncommonly, small and early cancers are misdiagnosed as benign anorectal disorders like anal fissures or hemorrhoids. The clinical suspicion of squamous cell carcinoma of the anus is of paramount importance in patients with nonhealing anal fissures, fissures in atypical positions or with indurated or ulcerated anal tags and in patients with risk factors for the development of anal squamous intraepithelial lesions that are precursors of invasive anal squamous cell carcinoma. The authors present 3 cases of squamous cell carcinoma of the anus initially misdiagnosed as benign chronic anal fissure.

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Anal cancer: Current standards in care and recent changes in practice

Cited by 90 publications

References 180 publications

Evaluation of anal cytology and dysplasia in women with a history of lower genital tract dysplasia and malignancy

Evaluation of anal cytology and dysplasia in women with a history of lower genital tract dysplasia and malignancy

Results of Surgical Salvage Treatment for Anal Canal Cancer: A Retrospective Analysis with Overview of the Literature

A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure

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