Squamous cell carcinoma of the rectum: The treatment paradigm

Musio, Daniela; Felice, Francesca De; Manfrida, S.; Boccadoro, Mario; Meldolesi, Elisa; Gravina, Giovanni Luca; Tombolini, Vincenzo; Valentini, Vincenzo

doi:10.1016/j.ejso.2015.03.239

Cited by 37 publications

(28 citation statements)

References 27 publications

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“…Surgical resection is a consideration , but increasing numbers of recent studies are also finding merit to treat with definitive CRT using the anal SCC paradigm . Along with the data herein, several series have shown high clinical response as well as clinical complete response rates from 63% to 100% along with 5‐year overall survival, disease‐free survival, and disease‐specific survival rates of 81%, 72%, and 88%, respectively .…”

Section: Discussionmentioning

confidence: 60%

“…the anal SCC paradigm [21,22]. Along with the data herein, several series have shown high clinical response as well as clinical complete response rates from 63% to 100% along with 5-year overall survival, disease-free survival, and disease-specific survival rates of 81%, 72%, and 88%, respectively [9,[23][24][25][26][27][28].…”

Section: Squamous Cell Carcinoma Adenocarcinomamentioning

confidence: 59%

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Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma

et al. 2016

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Large, population‐based analyses of rectal squamous cell carcinoma (SCC) have not been previously conducted. We assessed patterns of care, prognostic factors, and outcomes of rectal SCC and adenocarcinoma (AC) in population‐based cohorts. Surveillance, Epidemiology, and End Results (SEER) registry searches were performed (1998–2011), producing 42,308 nonmetastatic rectal cancer patients (999 SCC and 41,309 AC). Patient, tumor, and treatment characteristics were compared. Based on risk factors, SCC/AC groups were subdivided into low‐, intermediate‐, and high‐risk groups. Overall survival (OS) was compared between histological and risk groups using Kaplan–Meier method and log‐rank test. Multivariate logistic regression models evaluated prognostic factors for 5‐year survival. Cox regression modeling was performed on propensity‐matched data. Rectal SCC, more common in females and associated with larger tumors of higher grade, was more often treated with radiotherapy (RT) than surgery. Surgery was associated with higher OS in AC but not SCC, and RT had proportionally greater benefits in SCC. These effects of RT and surgery were retained when stratified into risk groups (particularly high/intermediate‐risk). Favorable prognostic factors for survival included younger age, non‐black race, SCC histology, size ≤3.9 cm, localized stage, lower grade, surgery, and RT. For SCC, race, tumor grade, and surgery were not prognostic factors for survival. Cox regression modeling of propensity‐matched data showed that AC histology increased risk of death versus SCC. In the largest analysis of rectal SCC to date, and in the notable absence (and unlikelihood) of prospective data, nonsurgical and RT‐based treatment is recommended.

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Section: Discussionmentioning

confidence: 60%

Section: Squamous Cell Carcinoma Adenocarcinomamentioning

confidence: 59%

Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma

et al. 2016

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“…There has also been similar shift in preference towards definitive chemo-radiation for Rectal SCC [15,16,18,19]. A systematic review comparing chemo-radiation with traditional surgical approach demonstrated an overall survival of 86% in the chemoradiation group vs. 48% in surgery group.…”

Section: Discussionmentioning

confidence: 99%

Rare Primary Sub-Mucosal Rectal Squamous Cell Carcinoma Diagnosed with Endoscopic Ultrasound: Case Report and Literature Review

Sethi¹,

Aloreidi²,

Elnair³

et al. 2017

J Gastrointest Dig Syst

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Primary rectal Squamous Cell Carcinoma (SCC) is a distinct and extremely rare form of colorectal malignancy and submucosal rectal SCC is rarer. The etiology and pathogenesis of rectal SCC is poorly understood. Given the rare occurrence of this type of malignancy, there are a number of diagnostic and therapeutic dilemmas. We are reporting a case of a 56-year-old female, who presented with abdominal pain and found to have rectal mass which was subsequently biopsied under endoscopic ultrasound guidance. Histopathology showed primary submucosal squamous cell carcinoma. She was treated with radiotherapy and systemic chemotherapy. Now she is undergoing regular malignancy surveillance.

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“…They suggested regimen would be a total dose of 50.4 to 54 Gy external beam radiation in 1.8 Gy per fraction, given concurrently with 5FU and mitomycin C (3) . Musio et al (16) published a small series (8 patients) which were treated with radiotherapy (total radiation dose from 45 to 76.5 Gy) and chemotherapy (5 FU and mitomycin C most cases) combination. They reported only one recurrence that finally needed surgical resection.…”

Section: Discussionmentioning

confidence: 99%

Primary Squamous Cell Carcinoma of the Rectum Case Report with Literature Review

Abbassi

Touil²,

Echchikhi³

et al. 2017

IAM

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Background: Squamous cell carcinoma of the rectum is a distinct entity. We report a rare case of squamous cell carcinoma of the middle and low rectum. Case presentation: The patient was a 60-year-old man who presented with a history of rectal Bleeding, constipation and pelvic painless. Rectoscopy and Colonoscopy revealed a polypoid tumour of the middle and low rectum. Biopsies of this mass revealed a poorly differentiated squamous cell carcinoma of the rectum. Pelvic Magnetic Resonance Imaging scan showed a polypoid, irregular and circumferential tumor in the middle and low rectum extending in length on 95mm. CT scan of the chest, abdomen and pelvis was negative for distal metastases. The patient received combined chemo-radiation. Overall treatment time was 45 days. After 6 weeks of the end of treatment, the revaluation clinical tests by pelvic magnetic resonnance imaging showed a poor response. After 3 months, Positron Emission Tomography with Fluorodeoxyglucose demonstrated a little hypermetabolic area with maximum standard up take value of 6,7 in the low rectum. Patient underwent a surgical resection. The postoperative histopathological findings were non specific and chronic inflammatory changes. At the time this report was written, the patient had 18 months of follow-up. No evidence of malignacy is found. Conclusion: Squamous cell carcinoma of the rectum is a distinct entity. Chemoradiation should be chosen as the first-line therapy for suqamous cell carcinoma of the rectum. However,a large study will be required to establish a safe and effective regimen.

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Squamous cell carcinoma of the rectum: The treatment paradigm

Cited by 37 publications

References 27 publications

Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma

Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma

Rare Primary Sub-Mucosal Rectal Squamous Cell Carcinoma Diagnosed with Endoscopic Ultrasound: Case Report and Literature Review

Primary Squamous Cell Carcinoma of the Rectum Case Report with Literature Review

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