Prognosis of anal canal adenocarcinoma versus lower rectal adenocarcinoma in Japan: a propensity score matching study

Saiki, Yasumitsu; Yamada, Kazutaka; Tanaka, Masafumi; Fukunaga, Mitsuko; Irei, Yasue; Suzuki, Taneko

doi:10.1007/s00595-021-02350-1

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…There are no prospective clinical studies in patients with rectal or anal canal adenocarcinoma with only ILMN; only retrospective studies in a small number of cases have been reported. While long-term survival of more than 5 years was extremely rare in reports prior to 2000 [5][6][7], recent reports have reported 5-year survival rates of 15.9-55.2% [4,[20][21][22][23][24]. This study had the highest number of cases of radical resection for simultaneous metastases and the most favorable outcomes among papers reporting 5-year overall survival rates of 50% or greater [20][21][22].…”

Section: Discussionmentioning

confidence: 93%

“…The frequency of metastasis to the inguinal lymph nodes in advanced rectal or anal canal adenocarcinoma is 0.3-6%, depending on the tumor depth and dentate line involvement [1][2][3][4]. However, the treatment strategy for rectal or anal canal adenocarcinoma with inguinal lymph node metastasis (ILNM) has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

“…With the advancements in preoperative imaging [8,9], perioperative treatments [10][11][12][13][14], chemotherapy after recurrence [15,16], and the development of surgical techniques [17][18][19], the treatment outcomes of rectal adenocarcinoma have improved over the past two decades. Recent reports have shown an improved 5-year survival rate of 40-60% for primary rectal cancer patients with solitary ILNM [4,[20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for metastasised rectal or anal canal adenocarcinoma

Hasegawa

Matsuda

Yamashita

et al. 2022

Preprint

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Purpose Rectal or anal canal adenocarcinoma with inguinal lymph node metastasis (ILNM) is rare and is associated with poor prognostic outcomes. This study aimed to elucidate the clinical significance of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for rectal or anal canal adenocarcinoma with clinically suspected ILNM. Methods This study enrolled 15 consecutive patients who underwent neoadjuvant therapy and curative resection for rectal or anal canal adenocarcinoma with clinically suspected ILNM between 2005 and 2019 at a single institution. Inguinal lymph node dissection was selectively performed on the side of suspected metastasis before neoadjuvant therapy. Short- and long-term outcomes were retrospectively reviewed. Results Out of the15 patients, 11 were treated with neoadjuvant chemoradiation, three with chemotherapy, and one with chemoradiation followed by chemotherapy. Six patients had negative fluorodeoxyglucose (FDG) accumulation in inguinal lymph nodes on preoperative FDG-positron emission tomography (FDG-PET) scan, and their inguinal lymph nodes were also pathologically negative for metastasis. Of the nine patients who had positive FDG accumulation, four had pathologically positive inguinal lymph nodes. Seven patients (46.7%) had inguinal seroma postoperatively. Five-year-overall survival was 77.5%, and 5-year-relapse-free survival was 64.2%. No patient had a recurrence in the inguinal region. Conclusion In patients with rectal or anal canal adenocarcinoma associated with clinical ILNM, radical resection with neoadjuvant therapy provides a good long-term survival.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for metastasised rectal or anal canal adenocarcinoma

Hasegawa

Matsuda

Yamashita

et al. 2022

Preprint

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“…They estimated a 3.1% increase in the mortality rate. Anal and cervical carcinomas are not yet well understood [3][4][5]. Articles, such as Melbye and Sprogel [6] and Rabkin et al [7], have mentioned that anal and cervical cancers have common risk factors and other similarities.…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

Nonlinear Techniques and Ridge Regression as a Combined Approach: Carcinoma Identification Case Study

Perez

Castillo

2023

Mathematics

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As more genetic information becomes available, such as DNA methylation levels, it becomes increasingly important to have techniques to analyze such data in the context of cancers such as anal and cervical carcinomas. In this paper, we present an algorithm that differentiates between healthy control patients and individuals with anal and cervical carcinoma, using as an input DNA methylation data. The algorithm used a combination of ridge regression and neural networks for the classification task, achieving high accuracy, sensitivity and specificity. The relationship between methylation levels and carcinoma could in principle be rather complex, particularly given that a large number of CpGs could be involved. Therefore, nonlinear techniques (machine learning) were used. Machine learning techniques (nonlinear) can be used to model linear processes, but the opposite (linear techniques simulating nonlinear models) would not likely generate accurate forecasts. The feature selection process is carried out using a combination of prefiltering, ridge regression and nonlinear modeling (artificial neural networks). The model selected 13 CpGs from a total of 450,000 CpGs available per patient with 171 patients in total. The model was also tested for robustness and compared to other more complex models that generated less precise classifications. The model obtained (testing dataset) an accuracy, sensitivity and specificity of 97.69%, 95.02% and 98.26%, respectively. The reduction of the dimensionality of the data, from 450,000 to 13 CpGs per patient, likely also reduced the likelihood of overfitting, which is a very substantial risk in this type of modelling. All 13 CpGs individually generated classification forecasts less accurate than the proposed model.

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“…As such, ILNMs are deemed to represent distant metastatic or stage IV disease [ 10 ]. However, recent case series demonstrate significantly better survival outcomes for patients with ILNM treated with curative intent when compared to patients with distant solid organ metastatic disease [ 8 , 9 , 11 ], thereby suggesting the reduced survival outcomes associated with distant metastases should not apply to these patients.…”

Section: Introductionmentioning

confidence: 99%

Inguinal lymph node metastases from rectal adenocarcinoma: a systematic review

et al. 2023

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Purpose Inguinal lymph nodes are a rare but recognised site of metastasis in rectal adenocarcinoma. No guideline or consensus exists for the management of such cases. This review aims to provide a contemporary and comprehensive analysis of the published literature to aid clinical decision-making. Methods Systematic searches were performed using the PubMed, Embase, MEDLINE and Scopus and Cochrane CENTRAL Library databases from inception till December 2022. All studies reporting on the presentation, prognosis or management of patients with inguinal lymph node metastases (ILNM) were included. Pooled proportion meta-analyses were completed when possible and descriptive synthesis was utilised for the remaining outcomes. The Joanna Briggs Institute tool for case series was used to assess the risk of bias. Results Nineteen studies were eligible for inclusion, encompassing 18 case series and one population-based study using national registry data. A total of 487 patients were included in the primary studies. The prevalence of ILNM in rectal cancer is 0.36%. ILNM are associated with very low rectal tumours with a mean distance from the anal verge of 1.1 cm (95% CI 0.92–1.27). Invasion of the dentate line was found in 76% of cases (95% CI 59–93). In patients with isolated inguinal lymph node metastases, modern chemoradiotherapy regimens in combination with surgical excision of inguinal nodes are associated with 5-year overall survival rates of 53–78%. Conclusion In specific subsets of patients with ILNM, curative-intent treatment regimens are feasible, with oncological outcomes akin to those demonstrated in locally advanced rectal cancers.

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Prognosis of anal canal adenocarcinoma versus lower rectal adenocarcinoma in Japan: a propensity score matching study

Cited by 7 publications

References 23 publications

Clinical outcomes of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for metastasised rectal or anal canal adenocarcinoma

Clinical outcomes of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for metastasised rectal or anal canal adenocarcinoma

Nonlinear Techniques and Ridge Regression as a Combined Approach: Carcinoma Identification Case Study

Inguinal lymph node metastases from rectal adenocarcinoma: a systematic review

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