Recent advances in the management of anal cancer

Symer, Matthew M.; Yeo, Heather

doi:10.12688/f1000research.14518.1

Cited by 34 publications

(39 citation statements)

References 54 publications

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“…Approximately, 30% of patients with ASCC eventually undergo salvage abdominoperineal resection for recurrence or persistence of disease 25 . This is a remarkably morbid procedure, with complication rates as high as 72% 26 .…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia is associated with worse overall survival in patients with anal squamous cell cancer

Bingmer

Kondray

Ofshteyn

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: Sarcopenia is associated with poor long-term outcomes in many gastrointestinal cancers, but its role in anal squamous cell carcinoma (ASCC)is not defined. We hypothesized that patients with sarcopenic ASCC experience worse long-term outcomes.Methods: A retrospective review of patients with ASCC treated at an academic medical center from 2006 to 2017 was performed. Of 104 patients with ASCC, 64 underwent PET/computed tomography before chemoradiation and were included in the analysis.The skeletal muscle index was calculated as total L3 skeletal muscle divided by height squared. Sarcopenia thresholds were 52.4 cm 2 /m 2 for men and 38.5 cm 2 /m 2 for women.Cox regression analysis was performed to assess overall and progression-free survival.Results: Twenty-five percent of the patients were sarcopenic (n = 16). Demographics were similar between groups. There was no difference in the clinical stage or comorbidities between groups. On multivariate analysis, factors associated with worse overall survival were male gender (hazard ratio [HR] 3.7, P = .022) and sarcopenia (HR 3.6, P = .019). Male gender was associated with worse progression-free survival (HR 2.6, P = .016).Conclusions: Sarcopenia is associated with worse overall survival in patients with anal cancer. Further studies are indicated to determine if survival can be improved with increased attention to nutritional status in sarcopenic patients. K E Y W O R D Sanal cancer, chemoradiation, sarcopenia

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Section: Discussionmentioning

confidence: 99%

Sarcopenia is associated with worse overall survival in patients with anal squamous cell cancer

Bingmer

Kondray

Ofshteyn

et al. 2020

Journal of Surgical Oncology

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“…41,42 High-risk human papilloma virus (HPV) infection is associated with 91% of SCCA cases, though links also exist with immunosuppression, smoking, and advancing age. 43,44 The unique association of SCCA with HPV has led to question the role of the immune system in the development and subsequent treatment of this pathology. Interestingly, HPV-infected malignant cells (p16 positive) and expression of HPV-associated oncogenes-much of which has been studied in cervical cancer-have been shown to reduce immune recognition through several mechanisms resulting in an immunosuppressive environment.…”

Section: Immuno-oncology In Anal Cancermentioning

confidence: 99%

Advances in Immuno-oncology for the Treatment of Colorectal and Anal Cancers

Uboha

Grogan

Deming

2021

Digestive Disease Interventions

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Immune checkpoint inhibitors changed treatment paradigms across several malignancies. With the exception of tumors with microsatellite instability (MSI-H), gastrointestinal cancers have been largely resistant to these agents. Herein, we review the data supporting the use of immunotherapy for patients with (MSI-H) colorectal tumors. We discuss ongoing research and answered questions regarding resistance and sequence of use of these agents for this disease. We discuss ongoing research efforts to augment activity of these agents in microsatellite stable colorectal cancer. We also provide an overview of the data and ongoing studies immune checkpoint inhibitors in the treatment of anal cancer.

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“…The most common type of anal cancer is the squamous epithelium type, which is based on cells in the anal canal or immediately around the anus. The majority of anal cancers are caused by HPV (51). Further risk factors for anal cancer are human immunodeficiency virus (HIV), more than ten lifetime sexual partners, anoreceptive intercourse, chronic immunosuppression, smoking, and a history of gynecological or hematological malignancy (49).…”

Section: Anal Cancermentioning

confidence: 99%

“…For one group of patients, surgery is the only treatment, for others surgery is combined with radiotherapy, and for a third group surgery is combined with both radiotherapy and chemotherapy. However, the primary treatment option is radiotherapy, in combination with chemotherapy (48,51).…”

Section: Anal Cancermentioning

confidence: 99%

Incontinence, physical activity, and pelvic floor muscle training in female pelvic cancer survivors after radiotherapy

Lindgren

2020

Linköping University Medical Dissertations

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Background: Cancer treatment continues to improve, contributing to an evergrowing population of cancer survivors. Pelvic cancer survivors (PCS) constitute the second largest group of female cancer survivors after breast cancer. Many female PCS have been treated with radiotherapy as a part of their cancer treatment. Unfortunately, like all effective cancer treatments, pelvic radiotherapy is associated with a risk of subsequent, unwanted side effects. Some side effects remain or persist long after the end of treatment and some are even lifelong. A common and burdensome side effect after pelvic radiotherapy is urinary and/or fecal incontinence. Incontinence is known to negatively affect quality of life (QoL) and physical activity levels. Physical activity contributes to several positive health effects. In cancer survivors, it may reduce the risk of recurrence and even the mortality risk. Cancer survivors in general, and female PCS in particular, tend to be less physically active after cancer treatment than before treatment. When suffering from urinary and even fecal incontinence, pelvic floor muscle training (PFMT) is recommended as a first-line treatment for the general population. In addition to decreased incontinence levels, PFMT may contribute to increased physical activity and better QoL. However, little attention is given to PFMT as a potential treatment for incontinence in the Swedish national care program for pelvic cancer rehabilitation. Furthermore, there is as yet no evidence that PFMT is as effective in female PCS as in female non-cancer survivors. The effectiveness of PFMT cannot be taken for granted because female PCS survivors often have treatment-induced damage to structures in the pelvic floor that might affect its applicability. However, the problem of incontinence among female PCS remains, along with the fact that they tend to be less physically active than other cancer survivors. Indeed, this is an important research area and a necessary problem for health-care providers to resolve, not least for physiotherapists. Aim: The overall aim of this thesis is to improve the understanding of female PCS' experiences of incontinence in relation to physical activity, QoL, and rehabilitative efforts, including PFMT. This includes gaining increased knowledge about the relation between incontinence and physical activity in the form of exercise and QoL, and whether PCS experience that physiotherapy contributes in a valuable way to reducing their incontinence. This could enable the development of meaningful physiotherapeutic interventions, that PCS can and are willing to engage in, to achieve a potential reduction in incontinence, as well as increased QoL and activity levels. Methods: The thesis includes four different studies, using three different methods, all conducted with female PCS. Studies I (n=13) and IV (n=11) are qualitative individual interview studies, using semi-structured interview guides. Study II is a cohort-based cross-sectional observational study (n=578) and Study III is a prospective cohort-b...

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Recent advances in the management of anal cancer

Cited by 34 publications

References 54 publications

Sarcopenia is associated with worse overall survival in patients with anal squamous cell cancer

Sarcopenia is associated with worse overall survival in patients with anal squamous cell cancer

Advances in Immuno-oncology for the Treatment of Colorectal and Anal Cancers

Incontinence, physical activity, and pelvic floor muscle training in female pelvic cancer survivors after radiotherapy

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