Multimodality treatment of oligometastatic anal squamous cell carcinoma: A case series and literature review

Sclafani, Francesco; Hesselberg, Gina; Thompson, Stephen R.; Truskett, Philip G.; Haghighi, Koroush S.; S, Rao; Goldstein, David

doi:10.1002/jso.25320

Cited by 13 publications

(6 citation statements)

References 30 publications

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“…The liver is the most frequent site of distant metastases in patients with anal SCC, of which approximately 20 per cent develop liver metastases 15 . In the present study, the median OS of 50 months and corresponding 5-year OS of 45 per cent compares favourably to other reports on outcome of patients treated for liver-metastatic anal cancer, reporting a median OS of between 22 and 53 months 2 , 5 , 14 , 16 , 17 .…”

Section: Discussionsupporting

confidence: 83%

Liver resection and ablation for squamous cell carcinoma liver metastases

et al. 2021

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Background Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method Members of the European–African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

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Section: Discussionsupporting

confidence: 83%

Liver resection and ablation for squamous cell carcinoma liver metastases

et al. 2021

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“…However, this is not a head-to-head comparison and should be interpreted with caution. Results of principal studies for metastatic SCCA treated with CT alone or with pelvic RT are summarized in Supplementary Table 3 (16,17,19,21,25,33,(40)(41)(42)(43).…”

Section: Discussionmentioning

confidence: 99%

“…Nine patients (56%) completed their RT without interruption. The median OTT in these patients was 47 days [range, [42][43][44][45][46][47][48][49][50][51][52]. Compliance with concurrent CT is detailed in Supplementary Table 2.…”

Section: Compliance With Crtmentioning

confidence: 99%

Long-Term Disease Control After locoregional Pelvic Chemoradiation in Patients with Advanced Anal Squamous Cell Carcinoma

Grave

Blanc²,

Bari³

et al. 2022

Front. Oncol.

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IntroductionThe incidence of metastatic squamous cell carcinoma of the anus (SCCA) is increasing. Even if systemic docetaxel, cisplatin, and 5-Fluorouracil (DCF) provide a high rate of long-term remission, the role of pelvic chemoradiation (CRT) is unknown in this setting. We reported the safety and efficacy of local CRT in patients with synchronous metastatic SCCA who achieved objective response after upfront DCF.MethodsPatients included in Epitopes HPV01 or Epitopes HPV02 or SCARCE trials and treated with DCF followed by pelvic CRT were included. Concurrent chemotherapy was based on mitomycin (MMC) (10 mg/m² for two cycles) and fluoropyrimidine (capecitabine 825 mg/m² twice a day at each RT treatment day or two cycles of intra-venous 5FU 1000 mg/m² from day 1 to day 4). Primary endpoints were safety, local complete response rate, and local progression-free survival (PFS). Secondary endpoints were PFS, overall survival (OS), and metastasis-free survival (MFS).ResultsFrom 2013 to 2018, 16 patients received DCF followed by a complementary pelvic CRT for advanced SCCA. Median follow-up was 42 months [range, 11-71]. All patients received the complete radiation dose. Compliance to concurrent CT was poor. Overall, 13/15 of the patients (87%) had at least one grade 1-2 acute toxicity and 11/15 of the patients (73%) had at least one grade 3-4 toxicity. There was no treatment-related death. The most frequent grade 3-4 adverse effects were neutropenia (36%), dermatitis (40%), and anitis (47%). Eleven patients (73%) had at least one chronic grade 1 or 2 toxicity. One patient had a grade 4 chronic rectitis (7%). Complete local response rate was 81% at first evaluation and 62.5% at the end of the follow-up. Median local PFS was not reached and the 3-year local PFS was 77% (95%CI 76.8-77).ConclusionsIn patients with metastatic SCCA who had a significant objective response after upfront DCF, local CRT was feasible with high complete local response rate. The good local control rate, despite interruptions due to toxicities and low CT compliance, underline the role of pelvic RT. The high rate of toxicity prompts the need to adapt CRT regimen in the metastatic setting.

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“…In another small series based on two centres in the UK and Australia, four of the five patients with hepatic metastasis of anal SCC underwent surgery. Only one patient underwent radiofrequency ablation with radiation of the hepatic metastasis 5. Most of the survival data are derived from the management of colorectal and neuroendocrine hepatic metastases with 5-year survival up to 30%–58% and 60%–76%, respectively 4…”

Section: Discussionmentioning

confidence: 99%

Hepatic metastasis of anal squamous cell carcinoma

Navadgi

Gunawardena

et al. 2022

BMJ Case Rep

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A 50-year-old woman was diagnosed with anal squamous cell carcinoma following a colonoscopy performed for positive test from the National Bowel Screening Programme. During the staging imaging, it was discovered to have a liver lesion that was atypical for metastasis. She underwent a segmental liver resection, and histopathology showed the liver lesion as a metastatic squamous cell carcinoma. We aim to discuss the incidence, presentation and management strategies for this rare hepatic metastasis of anal squamous cell carcinoma.

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Multimodality treatment of oligometastatic anal squamous cell carcinoma: A case series and literature review

Cited by 13 publications

References 30 publications

Liver resection and ablation for squamous cell carcinoma liver metastases

Liver resection and ablation for squamous cell carcinoma liver metastases

Long-Term Disease Control After locoregional Pelvic Chemoradiation in Patients with Advanced Anal Squamous Cell Carcinoma

Hepatic metastasis of anal squamous cell carcinoma

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