Background: Colorectal cancer is the third most common cancer in the United States and associated with significant morbidity and mortality. Within colorectal cancer histologies, squamous cell carcinomas (SCC) are rare compared to adenocarcinomas, with only about 200 cases reported to date. Because rectal SCC is rarely encountered, there is a lack of literature and clinical consensus surrounding its optimal treatment approach. Staging and management of SCC can be partly analogous to both rectal adenocarcinoma and anal canal SCC, which leads to a dilemma in how to best approach these patients. As large randomized prospective trials are unrealistic in the setting of this rare malignancy, this study evaluates an institutional experience and reviews the existing literature to help guide future management approaches.
Methods: This retrospective study compared various treatment regimens for rectal SCC patients treated at Duke University Medical Center from January 1, 1980 through December 31, 2016. Patients ≥18 years old with histologically confirmed, nonmetastatic rectal SCC were included. Due to small sample size, all statistical analyses were descriptive. For our systematic review, a comprehensive search of PubMed from 1933 to March 2018 was performed, with selected articles referenced to ensure all relevant publications were included. A qualitative analysis was performed to examine patient diagnoses, treatments, and disease- and treatment-related outcomes.
Results: Eight patients were included. Three patients underwent initial, curative attempt surgery and two of these patients required colostomy. With follow-up ranging from 7.1 to 31.5 months, one patient was alive with no evidence of disease while two developed local/regional recurrences. Five patients received definitive chemoradiation. Of these, three patients developed local/regional and/or metastatic recurrence. Two patients achieved complete response on imaging and currently remain disease-free (follow-up of 31.5 and 33.6 months).
Conclusions: Although the review of our institutional experience is limited by small numbers, our analysis suggests that definitive chemoradiation therapy is the preferred treatment approach to rectal SCC based on improved disease-related outcomes, sphincter preservation and morbidity profiles. This conclusion is supported by a systematic literature review.
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http://dx.doi.org/10.21037/jgo.2018.11.02 | DOI Listing |
Surg Oncol Clin N Am
January 2025
Colon & Rectal Surgery, Department of Surgery, University of Michigan, 1500 East Medical Center Drive, 2900 Taubman Center, Ann Arbor, MI 48109, USA. Electronic address:
Anal cancer, though rare, is witnessing an annual increase in incidence, predominantly of squamous cell carcinoma (SCC). Prevention strategies revolve around reducing risk factors such as human papillomavirus (HPV) infection, human immunodeficiency virus/acquired immunodeficiency syndrome, immunosuppression, smoking, and high-risk sexual practices, while advocating for HPV vaccination. The Anal Cancer-HSIL Outcomes Research trial validates treating anal high-grade squamous intraepithelial lesion to curb SCC development.
View Article and Find Full Text PDFClin Radiol
October 2024
Imperial College London (Department of Surgery and Cancer), Department of Surgery and Cancer, Imperial College, Room BN1/2, B Block 1st Floor, Hammersmith Campus, Imperial College, Du Cane Road, W12 0HS, UK. Electronic address:
Aim: This study aimed to determine the prognostic significance of length of tumour (mrT stage) and depth of extramural spread (mrEMS) in anal squamous cell cancer (SCC) treated by chemoradiation with curative intent. Locally advanced anal SCC (T3-4 N+) have poorer prognosis, but it is unknown whether the lateral spread of the tumour (extramural spread beyond the bowel wall) also confers poor prognosis in anal SCC, as it does for rectal cancer. T stage and mrEMS can be readily assessed by pelvic magnetic resonance imaging (MRI) routinely undertaken to stage anal SCC.
View Article and Find Full Text PDFAnimals (Basel)
October 2024
Ruminant Research Group (G2R), Department of Animal and Food Sciences, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain.
This study evaluated short-term immune responses of dairy ewes supplemented with barley β-glucan (BG) following an intramammary lipopolysaccharide (LPS) challenge. In the adaptation period, 36 ewes were fed an alfalfa hay diet ad libitum and barley grain cv. Hispanic (3.
View Article and Find Full Text PDFJ Surg Case Rep
August 2024
Department of Colon and Rectal Surgery, Hospital Médica Sur, Mexico City, Mexico.
Anal cancer is uncommon, comprising 2.2% of gastrointestinal cancers. Squamous cell carcinoma (SCC) is the most common; while perianal basal cell carcinoma (BCC) is rare, representing only 0.
View Article and Find Full Text PDFJ Natl Cancer Inst
August 2024
Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Purpose: To assess the effectiveness and harms of initial treatment strategies for stages I-III anal squamous cell cancer (SCC).
Methods: We searched Medline®, Embase®, and CENTRAL®, between January 1, 2000- March 2024, for randomized controlled trials and nonrandomized studies of interventions comparing initial treatment strategies. Individual study risk of bias (RoB) and overall strength of evidence (SOE) were evaluated for a prespecified outcome list using standardized methods.
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