Outcomes and Prognostic Factors for Squamous-Cell Carcinoma of the Anal Canal

Bilimoria, Karl Y.; Bentrem, David J.; Rock, Colin E.; Stewart, Andrew K.; Ko, Clifford Y.; Halverson, Amy L.

doi:10.1007/dcr.0b013e31819eb7f0

Cited by 133 publications

(97 citation statements)

References 34 publications

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“…This controversy in the terms used to describe tumor location was further explored by Wendell-Smith in 2000 [50]. The surgical definition of the anal canal, proposed by the American Joint Committee on Cancer (AJCC), is the most widely accepted [51,52]. By its definition, the anal canal extends from the apex of the anal sphincter complex to the palpable intersphincteric groove at the distal edge of the internal sphincter muscle.…”

Section: Mucosal Terminologymentioning

confidence: 99%

The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology

Darragh

Colgan

Cox

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

642

372

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The terminology for human papillomavirus (HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was cosponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the ultimate goal of providing optimal patient care.

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Section: Mucosal Terminologymentioning

confidence: 99%

The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology

Darragh

Colgan

Cox

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

642

372

View full text Add to dashboard Cite

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“…In the US, a study of 38,882 patients with anal cancer found that those undergoing recommended treatment (primary chemoradiotherapy with or without surgery) had an 18% lower risk of death within five years than those who underwent non-guideline treatment [14]. Large singlecentre series have shown similar results.…”

Section: Yorkshire Datamentioning

confidence: 99%

The Effect of the UK Coordinating Centre for Cancer Research Anal Cancer Trial (ACT1) on Population-based Treatment and Survival for Squamous Cell Cancer of the Anus

et al. 2015

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“…Systemic spread is uncommon with distant extra-pelvic metastases reported in 5% to 8% at initial diagnosis. Unfortunately, the prognosis for patients with metastatic disease remains poor with an estimated five-year OS of only 19% (9).…”

Section: Introductionmentioning

confidence: 99%

Successful hepatectomy for metastatic squamous cell carcinoma of the anal canal—a case report

Sousa

Santos

Belotto

et al. 2016

J. Gastrointest. Oncol.

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Abstract:Despite rare, metastatic anal carcinoma confers a poor prognosis. Systemic chemotherapy is the mainstay of treatment for advanced disease while the role of biologics and/or surgical resection of metastatic disease are anecdotal. Compared to isolated liver colorectal or neuroendocrine cancer liver metastases, there is far less experience with resection or nonsurgical local ablative procedures for patients with metastatic anal carcinoma to the liver. We report the case of a 67-year-old woman with metastatic anal carcinoma to the liver who was successfully treated with liver resection and remains free of relapse more than one year later. pelvis, which showed a 5.1-cm anal canal lesion as well as enlarged bilateral inguinal lymph nodes (2.0 cm), consistent with a clinical stage IIIB. At that time, the patient was treated with standard chemoradiation (CRT) consisting of mitomycin C (12 mg/m 2 , given on day 1) and Capecitabine (825 mg/m 2 twice daily during the days of radiotherapy). KeywordsThe total radiation therapy dose was 54 Gy in 27 fractions. During CRT, she developed grade 3 cutaneous radiation dermatitis and grade 3 diarrhea. Clinical examination four weeks after finishing CRT revealed complete regression of the anal tumor with no palpable inguinal lymphadenopathy. Nevertheless, 4 months after the completion of CRT, she developed at least three metastatic liver lesions in segments V and VI, measuring approximately 3.6 cm each. She was treated with 6 cycles of weekly Paclitaxel (80 mg/m²) and Cetuximab (400 mg/m² in the first cycle followed by 250 mg/m²). A repeat CT scan as well as a PET-CT scan revealed considerable increase in the size of the larger liver mass, which measured 13.1 cm × 10.7 cm × 10.6 cm, without new metastases (Figures 1 and 2). At that point, the patient was complaining of intense fatigue, anorexia, as well as upper abdominal pain. She was confined to bed with an extremely poor quality of life. Her lactate dehydrogenase (LDH) level was 1,045 U/L (normal values: 180-460 U/L). After extensive discussion with the patient and her family, it was decided to proceed with right hepatectomy. The postoperative period was uncomplicated and the patient was discharged home six days later. Histological findings of the resected specimen demonstrated metastatic squamous cell carcinoma with extensive necrosis, consistent with the known primary tumor of the anal canal, with free margins. Thirteen months after surgery, the patient remains remarkably well and free of recurrence (Figures 3 and 4). DiscussionIn patients with primary tumors of the gastrointestinal tract (especially colorectal adenocarcinoma and small intestine neuroendocrine tumors), the most likely mode of spread to the liver is through portal venous drainage or via direct intra-abdominal lymphatic channels. For other primary malignancies, metastases commonly reach the liver via systemic circulation, implying that extra-hepatic sites may have the same probability of being involved. Based on this rationale, hepatic resection of non-co...

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Outcomes and Prognostic Factors for Squamous-Cell Carcinoma of the Anal Canal

Abstract: Although tumor characteristics and staging affect prognosis, patient factors, such as gender, race, and socioeconomic status, are also important prognostic factors for squamous-cell carcinoma of the anal canal.

Cited by 133 publications

References 34 publications

The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology

The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology

The Effect of the UK Coordinating Centre for Cancer Research Anal Cancer Trial (ACT1) on Population-based Treatment and Survival for Squamous Cell Cancer of the Anus

Successful hepatectomy for metastatic squamous cell carcinoma of the anal canal—a case report

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