Patterns of local disease failure and outcome after salvage surgery in patients with anal cancer

Renehan, Andrew G; Saunders, Mark; Schofield, Philip F.; O’Dwyer, Sarah T

doi:10.1002/bjs.4908

Cited by 150 publications

(118 citation statements)

References 36 publications

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“…There are few data available about predictors of local failure, but one retrospective study was identified [42]. Renehan and colleagues evaluated outcomes of 254 patients with anal cancer treated with either radiotherapy alone (n ϭ 127) or combined chemoradiation (n ϭ 127) between 1988 and 2000 at a hospital in the United Kingdom.…”

Section: Persistent or Recurrent Diseasementioning

confidence: 99%

Anal Cancer: An Overview

2007

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LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Discuss the epidemiology of and the risk factors for anal cancer.2. Outline standard treatment for anal cancer and describe its complications.3. Understand the issues related to treating HIV-positive patients with anal cancer.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTAnal cancer is a rare tumor with an incidence that has been rising over the last 25 years. The disease was once thought to develop as a result of chronic irritation, but it is now known that this is not the case. Multiple risk factors, including human papillomavirus (HPV) infection, anoreceptive intercourse, cigarette smoking, and immunosuppression, have been identified. HIV infection is also associated with anal cancer; there is a higher incidence in HIV-positive patients but the direct relationship between HIV and anal cancer has been difficult to separate from the prevalence of HPV in this population. HIV infection is also associated with anal cancer; there are increasing numbers of HIV-positive patients being diagnosed with the disease. Treatment of anal cancer prior to the 1970s involved abdominoperineal resection, but the standard of care is now concurrent chemoradiation therapy, with surgery reserved for those patients with residual disease. We present a case of anal cancer followed by a general discussion of both risk factors and treatment. The Oncologist 2007;12: 524 -534 Disclosure of potential conflicts of interest is found at the end of this article. CASE PRESENTATIONA 63-year-old man with a past medical history significant for HIV managed with highly active antiretroviral therapy (HAART) (last CD4 count, 458) and anal squamous cell carcinoma in situ resected in 2000 presented for a routine colonoscopy in July 2006. The examination revealed a 12-mm nodule in the rectum, which was biopsied; pathology revealed invasive squamous cell carcinoma. Subsequent proctoscopy revealed a firm 2-cm mass located just beyond the dentate line. Transrectal ultrasound revealed evidence of invasion. Staging computed tomography (CT) scan revealed numerous low attenuation lesions in the liver concerning for metastasis but no evidence of abdominal or pelvic adenopathy. The patient was referred to gastrointestinal oncology to discuss treatment options.

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Section: Persistent or Recurrent Diseasementioning

confidence: 99%

Anal Cancer: An Overview

2007

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“…São dados semelhantes aos da literatura que mostraram eficácia entre 50 e 90% dos doentes, dependendo do tamanho do tumor 23 e do estádio da doença. 33 Também foi citado que a RT/QT é menos eficaz nos doentes mais idosos. 33 Conseguimos a remissão completa em todos os tumores nos estádios mais iniciais (I e II) e em 75% daqueles nos estádios IIIa e IIIb.…”

Section: Discussionunclassified

“…33 Também foi citado que a RT/QT é menos eficaz nos doentes mais idosos. 33 Conseguimos a remissão completa em todos os tumores nos estádios mais iniciais (I e II) e em 75% daqueles nos estádios IIIa e IIIb. Já entre os tumores da margem anal o controle cirúrgico foi obtido nos dois doentes, sendo que a RT/QT foi realizada posteriormente.…”

Section: Discussionunclassified

Avaliação dos resultados do tratamento de 14 doentes de carcinoma espinocelular anal

Lap¹,

Sha²,

Dl³

et al. 2006

Rev bras. colo-proctol.

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“…For example, a study of 308 patients in the Stockholm region of Sweden found that patients treated with neoadjuvant platinum-based chemotherapy had significantly better complete response rates and increased overall five-year survival than patients treated with radiotherapy with or without bleomycin [15]. In the UK, a series of 254 treated at a regional cancer centre demonstrated that chemoradiotherapy was associated with a significant improvement in local control in comparison to radiotherapy alone and this effect persisted six years after initial treatment [16].…”

Section: Yorkshire Datamentioning

confidence: 99%