Role of metastasectomy for liver metastasis in stage IV anal cancer

Goldner, Matthew; Platoff, Rebecca; Betances, Avril; Leo, Nicholas De; Gaughan, John; Alexander, Hannah; Atabek, Umur; Spitz, Francis R.; Hong, Young Ki

doi:10.1016/j.amjsurg.2020.08.016

Cited by 12 publications

(19 citation statements)

References 13 publications

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“…Nevertheless, approximately 20% of patients have hepatic metastases on presentation of anal SCC with a relatively poor 5-year survival of 19% 1. There is a paucity of data on hepatic metastasectomy in the setting of anal SCC as compared with colorectal and neuroendocrine hepatic metastases 2–4. The management of these hepatic metastases can range from isolated hepatic resections to combination of ablative therapies, portal vein embolisation, selective internal radiation therapy and hepatic artery infusion of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these strategies are discussed in the multidisciplinary meeting and decided based on individual cases where the number of liver lesions, locations and resectability are upfront. In a large study based on the National Cancer Database, there was no details on whether other interventions were used in combination of liver resections for metastatic anal SCC 4. 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.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…The optimal sequence of these treatment modalities is not established 4 6. In metastatic anal SCC, the treatment should be multimodal.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, approximately 20% of patients have hepatic metastases on presentation of anal SCC with a relatively poor 5-year survival of 19% 1. The data on hepatic metastasectomy in the setting of anal SCC are limited to small series as compared with colorectal and neuroendocrine hepatic metastases 2–4. Despite the reported incidence of up to 20% with distant metastases in anal SCC, it is a relatively rare presentation in daily clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The optimal sequence of these treatment modalities is not established 4 6. In metastatic anal SCC, the treatment should be multimodal.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepatic metastasis of anal squamous cell carcinoma

Navadgi

Gunawardena

et al. 2022

BMJ Case Rep

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Long‐term overall survival in patients undergoing liver resection for metastatic anal squamous cell carcinoma

Lo,

Dogeas,

Etherington

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesThere is limited research on management of metastatic anal canal squamous cell carcinoma (SCC) to the liver. This study aimed to describe outcomes for patients undergoing liver resection of anal SCC metastases.MethodsA multicenter, retrospective cohort study was conducted by three tertiary‐referral centers. Patients undergoing liver surgery between 2008 and 2022 were included. Cox regression analysis was performed to evaluate predictors of recurrence and survival and Kaplan–Meier analysis was performed for 1‐, 3‐, and 5‐year survival.ResultsTwenty‐one patients underwent liver resection and/or ablation. None were HIV positive and 24% had known HPV infection. 20/21(95%) patients had undergone Nigro protocol for management of the primary tumor with 12/21 (57%) patients experiencing complete response. 4/21 (19%) patients had synchronous liver metastases at time of diagnosis. Median tumor size was 5.0 cm and median tumor number was one. At analysis, 52% remained alive. Median overall survival was 32.2 months. 5‐year overall survival was 50%. Median recurrence‐free survival was 7.7 months and 5‐year recurrence‐free survival was 30%. Need for salvage abdominoperineal resection was negatively associated with recurrence‐free survival. The most common site of recurrence was the liver.ConclusionsLiver resection for metastatic anal SCC can be beneficial for appropriately selected patients.

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