Quality of life in patients treated for anal carcinoma—a systematic literature review

Sterner, Anton; Derwinger, Kristoffer; Staff, Caroline; Nilsson, Hanna; Angenete, Eva

doi:10.1007/s00384-019-03342-x

Cited by 30 publications

(28 citation statements)

References 52 publications

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“…Standard of care for most anal cancer patients is still a chemoradiotherapy (CRT) scheme, originally described by Nigro in the 1970s, that combines radiation therapy and chemotherapy with 5-fluorouracil and mitomycin [5]. However, CRT also causes a variety of short-and long-term side effects that may severely impair patients' quality of life [6]. Furthermore, some patients do not respond to CRT or cannot be treated because of contraindications.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of PD-L1 Expression and HPV Genotyping in Anal Squamous Cell Carcinoma

Wessely

Heppt

Kammerbauer

et al. 2020

Cancers

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Anal squamous cell carcinoma (SCC) is a rare cancer with increasing incidence. Infection with high-risk human papillomavirus (HPV) subtypes is the major cause for its development. We retrospectively analyzed tumor samples from 54 anal SCC patients for infection with a panel of 32 HPV subtypes in a PCR-based approach, determined the PD-L1 expression status, and correlated the findings with the clinical data and the survival of the patients. Forty-two patients (77.8%) were HPV-positive and harbored at least one carcinogenic HPV subtype. HPV16 was the most frequently detected (n = 39, 72.2%). Four patients were infected with multiple HPV subtypes. HPV infection was significantly more often detected in female than in male patients (90.3% vs. 60.9%, p = 0.018). Patients with PD-L1 positive tumors showed a significantly better median overall survival (OS) compared with patients with PD-L1 negative tumors (69.3 vs. 28.3 months, p = 0.006). The median OS was significantly different among the distinct tumor stages (p = 0.029). Sex, grade of differentiation, and HPV infection status did not influence the median OS. Furthermore, HPV infection status and PD-L1 expression were not correlated. A multivariate Cox regression analysis revealed that PD-L1 expression status was an independent prognostic marker for survival (p = 0.012).

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Section: Introductionmentioning

confidence: 99%

Evaluation of PD-L1 Expression and HPV Genotyping in Anal Squamous Cell Carcinoma

Wessely

Heppt

Kammerbauer

et al. 2020

Cancers

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“…This is an effective treatment curing a majority of the patients [1][2][3]. Importantly, after successful CRT many patients suffer from late sideeffects with a negative impact on the quality of life [4][5][6]. Therefore, for each individual patient, a careful balance must be struck between the chance of cure and the risk of severe toxicity.…”

Section: Introductionmentioning

confidence: 99%

Patterns of recurrence in anal cancer: a detailed analysis

Nilsson

Johnsson

et al. 2020

Radiat Oncol

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Background: Anal cancer is a rare disease, which might be the reason for the "one size fits all" approach still used for radiotherapy target contouring. To refine and individualize future guidelines, detailed and contemporary pattern of recurrence studies are needed. Methods: Consecutive anal cancer patients, all treated with curative intent intensity-modulated radiotherapy (IMRT), were retrospectively studied (n = 170). Data was extracted from medical records and radiological images. Radiotherapy planning CT's and treatment plans were reviewed, and recurrences were mapped and categorized according to radiation dose. Results: The mean dose to the primary tumor was 59.0 Gy. With a median follow-up of 50 months (range 14-117 months), 5-year anal cancer specific survival was 86.1%. Only 1 of 20 local recurrences was located outside the high dose (CTVT) volume. More patients experienced a distant recurrence (n = 34; 20.0%) than a locoregional recurrence (n = 24; 14.1%). Seven patients (4.2%) had a common iliac and/or para-aortic (CI/PA) recurrence. External iliac lymph node involvement (P = 0.04), and metastases in ≥3 inguinal or pelvic lymph node regions (P = 0.02) were associated with a 15-18% risk of CI/PA recurrence. Following chemoradiotherapy, 6 patients with recurrent or primary metastatic CI/PA lymph nodes were free of recurrence at last follow-up. The overall rate of ano-inguinal lymphatic drainage (AILD) recurrence was 2 of 170 (1.2%), and among patients with inguinal metastases at initial diagnosis it was 2 of 65 (3.1%). Conclusions: We conclude that other measures than increased margins around the primary tumor are needed to improve local control. Furthermore, metastatic CI/PA lymph nodes, either at initial diagnosis or in the recurrent setting, should be considered potentially curable. Patients with certain patterns of metastatic pelvic lymph nodes might be at an increased risk of harboring tumor cells also in the CI/PA lymph nodes.

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“…Its symptoms include changes in defecation frequency, rhythm disorder, incontinence, and constipation, which have been proven to seriously affect the postoperative quality of life [3]. About 30%-55% of patients with rectal cancer have severe LARS symptoms after they complete anal preservation surgery, which can last for several years [4,5].…”

Section: Introductionmentioning

confidence: 99%

A Novel Remote Follow-Up Tool Based on an Instant Messaging/Social Media App for the Management of Patients With Low Anterior Resection Syndrome: Pilot Prospective Self-Control Study (Preprint)

Liu¹,

Guo²,

Su³

et al. 2020

Preprint

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BACKGROUND Low anterior resection syndrome (LARS) is a common functional disorder that develops after patients with rectal cancer undergo anal preservation surgery. Common approaches to assess the symptoms of patients with LARS are often complex and time consuming. Instant messaging social media (IMSM) has great application potential in low anterior resection syndrome (LARS) follow-up, but has been underdeveloped. OBJECTIVE To compare data from a novel instant messaging social media (IMSM) follow-up system and a telephone interview (TI) in patients with low anterior resection syndrome (LARS) and to analyse the consistency of the IMSM platform. METHODS R0-resectable rectal cancer patients who accepted several defecation function visits via the IMSM platform and a telephone interview (TI) after the operation using the same questionnaire, including subjective questions and LARS scores, were included. Differences between the two methods were analysed in pairs and the diagnostic consistency of IMSM was calculated based on TI results. RESULTS In total, 21 questionnaires from 15 patients were included. The positive rates of defecation satisfaction, life restriction and medication use were 52.4%, 52.4%, 38.1% for TI and 52.4%, 61.9%, 23.8% for IMSM, respectively. No statistically significant difference was observed between IMSM and TI in terms of total LARS score (22.4 ± 11.9 vs 24.7 ± 10.7,P < 0.213) and LARS categories (Z = −0.264, P = 0.792); however, IMSM showed a more negative tendency. The Kappa values of three subjective questions were 0.618, 0.430 and 0.674, respectively. The total LARS scores were consistent between both groups (Pearson coefficient 0.760, P < 0.001; category correlation coefficient 0.570, P = 0.005). Patients with major LARS had highly consistent results, with sensitivity, specificity, kappa value and p of 77.8%, 91.7%, 0.704 and 0.001, respectively. CONCLUSIONS IMSM can be a significant LARS screening method. However, further research on information accuracy and user acceptance is needed before implementing a mature application. CLINICALTRIAL This study is a subproject of the registered study Bas-1611, which was registered on ClinicalTrail.org website and numbered NCT03009747 in January 2017.

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Quality of life in patients treated for anal carcinoma—a systematic literature review

Cited by 30 publications

References 52 publications

Evaluation of PD-L1 Expression and HPV Genotyping in Anal Squamous Cell Carcinoma

Evaluation of PD-L1 Expression and HPV Genotyping in Anal Squamous Cell Carcinoma

Patterns of recurrence in anal cancer: a detailed analysis

A Novel Remote Follow-Up Tool Based on an Instant Messaging/Social Media App for the Management of Patients With Low Anterior Resection Syndrome: Pilot Prospective Self-Control Study (Preprint)

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