Patterns of Failure and Outcome in Patients with Carcinoma of the Anal Margin

Khanfir, K.; Ozşahin, Mahmut; Bieri, Sabine; Cavuto, C.; Mirimanoff, R.O.; Zouhair, Abderrahim

doi:10.1245/s10434-007-9794-9

Cited by 29 publications

(27 citation statements)

References 18 publications

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“…It is likely that occult subclinical lymph node metastases were already present before and were probably detectable by an early PET scan, but this hypothesis could not be proven. Based on similar findings, some authors recently recommend elective irradiation for inguinal nodes, even for early-stage lesions, in most cases for two reasons: (1) the poor results of salvage treatment in case of inguinal relapse, and (2) about 15–25% of the patients with clinically uninvolved groin have occult metastases [24]. Others instead recommend an accurate initial lymph node staging and/or sentinel node biopsy technique [25,26].…”

Section: Discussionmentioning

confidence: 99%

Aggressive Treatment Approach for Cloacogenic Carcinoma of the Anorectum: Report from a Single Cancer Center

Bertani¹,

Chiappa²,

Mazzarol³

et al. 2010

Dig Surg

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Background/Aims: The prognosis of cloacogenic carcinoma of the anorectum has rarely been investigated, and its clinical behavior is supposed to be similar to common squamous anal cancers. During the last 10 years, chemoradiation treatment (CRT) has been considered the standard of care for anal cancer. Methods: We retrospectively investigated the treatment of cloacogenic cancers treated within the framework of a multidisciplinary cancer center team during an 8-year period. The medical records of 7 patients affected by cloacogenic carcinoma were analyzed. Three patients presented distant metastases at the time of diagnosis. CRT using 5-fluorouracil + mitomycin or cisplatin was considered the gold standard for those cases amenable to cure. Results: After a mean follow-up time of 33 months (range 9–100), disease recurrence or progression was observed in 6 patients, which caused death in 3 of them. Three- and 5-year actuarial overall survival rates were 71 and 48%, respectively. Conclusions: Our data seem to suggest that the cloacogenic origin could present prognostic relevance within the wide spectrum of anal cancers. This should be carefully considered when submitting patients to aggressive and prolonged treatments. However, this hypothesis needs to be confirmed by larger series of this disease.

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Section: Discussionmentioning

confidence: 99%

Aggressive Treatment Approach for Cloacogenic Carcinoma of the Anorectum: Report from a Single Cancer Center

Bertani¹,

Chiappa²,

Mazzarol³

et al. 2010

Dig Surg

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“…However, in a retrospective review of 45 patients from two institutions in Switzerland between 1983 and 2006, T or N stage, histologic grade, and chemotherapy administered did not affect rate of local regional control. 16 AJCC TNM Staging, 7 th EdiƟon (9) …”

Section: Outcomementioning

confidence: 99%

Squamous cell carcinoma of the anal margin

Times

Park

2015

Seminars in Colon and Rectal Surgery

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“…Anal margin cancers are less common than carcinomas of the anal canal and have a more favorable prognosis. [1][2][3][4] Squamous cell carcinoma (SCCA) of the anal margin represents one-fourth to one-third of all SCCA of the anus and is the most common of the anal margin tumors. 2,5 Most patients present between 65 to 75 years of age; however, there is a wide range with no clear predominance for either sex.…”

Section: Epidemiologymentioning

confidence: 99%

“…1 Superficial, well-differentiated T1 and early T2 lesions can be radiated through a perineal field alone; however, inguinal nodes are often irradiated as well due to the significant incidence of nodal disease even with small tumors. 1,3 More advanced lesions can be effectively treated with chemoradiation. Perineal and inguinal fields are often employed, even in the absence of clinically positive groin nodes.…”

Section: Stagingmentioning

confidence: 99%

Malignancies of the Anal Margin and Perianal Skin

Wietfeldt

Thiele

2009

Clinics in Colon and Rectal Surgery

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Malignancies of the anal margin and perianal skin are relatively uncommon lesions, comprising 3 to 4% of all anorectal malignancies. Commonly included in this group of cancers are Bowen's disease (intraepithelial squamous cell cancer), perianal Paget's disease (intraepithelial adenocarcinoma), invasive squamous cell cancer, basal cell cancer, and malignant melanoma. Buschke-Lowenstein tumor, or giant condyloma acuminatum, is not always included because this lesion is technically benign, although it displays aggressive local invasive behavior that makes it difficult to manage.Complaints are usually nonspecific, such as itching or burning, bleeding, pain, drainage, or a mass. Proper diagnosis requires a high index of suspicion on the part of the surgeon. Innocent local irritations will resolve in a short time with appropriate therapy; those that persist must be biopsied for tissue diagnosis.Wide local excision is the mainstay of treatment for early stage tumors as it preserves continence and obtains adequate local control. Adjunct therapies have been utilized in more advanced or recurrent lesions, including radiotherapy, photodynamic therapy, and imiquimod. All have met with a fair amount of success in controlling local disease; however, the number of patients treated in each instance is small, making it difficult to design an evidence-based treatment strategy. Invasion and metastasis are relatively rare in this group of neoplasms; perianal Paget's disease has the highest risk of associated underlying neoplasm. The most important consideration in developing a treatment strategy is which strategy would achieve the best clinical result with the least morbidity to the patient.

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Patterns of Failure and Outcome in Patients with Carcinoma of the Anal Margin

Abstract: We conclude that definitive RT and/or BT yield a good local control and disease-specific survival comparable with published data. This study suggests that radiation dose over 59.4 Gy seems to increase treatment-related morbidity.

Cited by 29 publications

References 18 publications

Aggressive Treatment Approach for Cloacogenic Carcinoma of the Anorectum: Report from a Single Cancer Center

Aggressive Treatment Approach for Cloacogenic Carcinoma of the Anorectum: Report from a Single Cancer Center

Squamous cell carcinoma of the anal margin

Malignancies of the Anal Margin and Perianal Skin

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