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1. Roth AD, Berney CR, Rohner S, Allal AS, Morel P, Marti MC, Aapro MS, Alberto P: Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential. Br J Cancer; 2000 Dec;83(12):1637-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential.
  • The prognosis of locally advanced or recurrent carcinomas of the penis (PE) and of the anal canal (AC) after conventional treatment is dismal.
  • We report 16 patients (eight with AC carcinomas and eight with PE cancers) treated by intra-arterial (IA) chemotherapy.
  • Fifteen of them were treated for locally advanced or recurrent disease and one in an adjuvant setting.
  • The chemotherapy was administered via a femoral IA catheter with its tip located above the aortic bifurcation, under the inferior mesenteric artery.
  • It consisted of eight push injections, given over a 48-h period, of the following drug combination: cisplatin 8.5 mg m(-2), 5-FU 275 mg m(-2), methotrexate 27.5 mg m(-2), mitomycin C 1.2 mg m(-2), and bleomycin 4 mg m(-2).
  • Leucovorin was given po, 4 x 15 mg day(-1), during the chemotherapy and for 3 days thereafter.
  • A total of 52 cycles of treatment were administered.
  • Among the complete responders, four are alive and disease-free 2-15 years after treatment.
  • Four patients developed grade III/IV haematological toxicity with three episodes of febrile neutropenia, one of them with a fatal outcome due to patient's failure to obtain medical attention at the onset of his fever, one a grade III mucositis of the glans, and four a grade III/IV cutaneous toxicity, the latter caused by the IA administration of bleomycin.
  • In conclusion, IA chemotherapy is effective and potentially curative in locoregionally advanced or recurrent carcinomas of the penis and of the anus.
  • Its contribution in the primary management of advanced penile or anal carcinoma should be prospectively investigated.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Penile Neoplasms / drug therapy
  • [MeSH-minor] Administration, Oral. Aged. Aged, 80 and over. Arteries. Bleomycin / administration & dosage. Bleomycin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Follow-Up Studies. Humans. Injections. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Neoplasm Recurrence, Local. Neutropenia / chemically induced. Skin Diseases / chemically induced. Treatment Outcome

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  • [Copyright] Copyright 2000 Cancer Research Campaign.
  • (PMID = 11104558.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] SCOTLAND
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
  • [Other-IDs] NLM/ PMC2363463
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2. Sana S, Khan AU: Clinical trials in the management of anal cancer. Clin Colon Rectal Surg; 2009 May;22(2):115-9
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  • [Title] Clinical trials in the management of anal cancer.
  • Our understandings of anal canal cancer pathogenesis and treatment have undergone significant changes due to continuing research into its pathogenesis and the results of major clinical trials conducted over the past 20 years.
  • Anal canal cancer can be cured by combined modality chemoradiation therapy, a treatment that preserves continence and reserves abdominoperineal resection of the rectum and anal canal in patients with recurrent or residual disease after primary chemoradiotherapy.
  • The research into more effective, less toxic therapies is continuing.
  • Future challenges include an increasing incidence of human papillomavirus infection, the AIDS epidemic, diagnosis of early disease, and optimization of chemotherapy and radiation regimens.
  • This article aims to provide a summary of recently completed and ongoing clinical trials in the management of anal canal cancer.

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  • (PMID = 20436836.001).
  • [ISSN] 1530-9681
  • [Journal-full-title] Clinics in colon and rectal surgery
  • [ISO-abbreviation] Clin Colon Rectal Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2780239
  • [Keywords] NOTNLM ; Anal canal cancer / chemotherapy / radiation therapy
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3. Yeh KY, Dunn P, Chang JW, Liaw CC: Microangiopathic hemolytic anemia in a patient with recurrent anal cancer and liver metastasis. Chang Gung Med J; 2002 Oct;25(10):706-10
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  • [Title] Microangiopathic hemolytic anemia in a patient with recurrent anal cancer and liver metastasis.
  • Microangiopathic hemolytic anemia (MAHA) is a late but fatal complication in advanced cancers (cancer-associated).
  • It may also appear in complete remission after chemotherapy (chemotherapy-related).
  • Squamous cell carcinoma with MAHA, on the other hand, has not often been reported in the English literature.
  • Because of the difficulty of case collection, understanding of the association of MAHA and anal squamous cell carcinoma remains vague.
  • We present a 60-year-old woman with anal cancer and liver metastasis.
  • This patient received chemotherapy (mitomycin C, 5-fluoruracil, and cisplatin) and reached a good partial response.
  • MAHA developed 2 months later, and tumor recurrence with rapid deterioration appeared 5 months later.
  • We consider that the MAHA in this patient is chemotherapy-related.
  • However, the possibility of cancer-associated MAHA could not be excluded.
  • [MeSH-major] Anemia, Hemolytic / etiology. Anus Neoplasms / complications. Carcinoma, Squamous Cell / complications. Liver Neoplasms / secondary. Neoplasm Recurrence, Local / complications
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Female. Humans. Middle Aged


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4. Nahas SC, Nahas CS, Silva Filho EV, Levi JE, Atui FC, Marques CF: Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report. Sao Paulo Med J; 2007 Sep 6;125(5):292-4
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  • [Title] Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report.
  • CONTEXT: Highly active antiretroviral therapy (HAART) has turned human immunodeficiency virus (HIV) infection into a chronic condition, and this has led to increased incidence of anal dysplasia among HIV-positive patients.
  • Routine anal evaluation including the anal canal and perianal area is recommended for this population, especially for patients infected by oncogenic human papillomavirus (HPV) types.
  • CASE REPORT: A 54-year-old homosexual HIV-positive man presented with a six-year history of recurrent perianal and anal warts.
  • He presented some condylomatous spreading lesions occupying part of the anal canal and the perianal skin, and also a well-demarcated slightly painful perianal plaque of dimensions 1.0 x 1.0 cm.
  • Both anal canal Pap smears and biopsies guided by high-resolution anoscopy revealed high-grade squamous intraepithelial lesion.
  • HPV DNA testing of the anus detected the presence of HPV-16 type.
  • Histological analysis on the excised tissue revealed high-grade squamous intraepithelial lesion with one focus of microinvasive squamous cell cancer measuring 1 mm.
  • The patient showed pathological evidence of recurrent anal and perianal high-grade squamous intraepithelial lesions at the sixth-month follow-up and required further ablation of those lesions.
  • However no invasive squamous cell carcinoma recurrence has been detected so far.
  • [MeSH-major] Antiretroviral Therapy, Highly Active / adverse effects. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. HIV Seropositivity / drug therapy. Human papillomavirus 16 / isolation & purification. Papillomavirus Infections / pathology
  • [MeSH-minor] Anal Canal / pathology. Anal Canal / virology. DNA, Viral / analysis. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis


5. Zampino MG, Magni E, Sonzogni A, Renne G: K-ras status in squamous cell anal carcinoma (SCC): it's time for target-oriented treatment? Cancer Chemother Pharmacol; 2009 Dec;65(1):197-9
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  • [Title] K-ras status in squamous cell anal carcinoma (SCC): it's time for target-oriented treatment?
  • PURPOSE: Squamous cell anal carcinoma (SCC) is an uncommon disease comprising only 1-5% of all intestinal tumours.
  • SCC is now considered the prototype for the successful application of conservative treatment as chemoradiation instead of aggressive surgery.
  • The EGFR status and k-ras mutations in SCC of the anal canal has not been well investigated.
  • METHODS: From June 1999 to December 2008, 32 patients affected by SCC were treated in our institution with chemotherapy containing Fluoropyrimidine and platinum salt concomitant with pelvic radiotherapy.
  • In all cases of our series wild-type K-ras was observed.
  • This observation previously reported in other tumours has supported the effective use of EGFR-inhibitors in recurrent or metastatic disease.
  • This observation could support the role of EGFR-inhibitors in the treatment of SCC.
  • [MeSH-major] Anus Neoplasms / genetics. Carcinoma, Squamous Cell / genetics. Proto-Oncogene Proteins / genetics. Receptor, Epidermal Growth Factor / genetics. ras Proteins / genetics
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Drug Delivery Systems. Female. Humans. Immunohistochemistry. Male. Middle Aged. Mutation. Retrospective Studies

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  • (PMID = 19727729.001).
  • [ISSN] 1432-0843
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / KRAS protein, human; 0 / Proto-Oncogene Proteins; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; EC 3.6.5.2 / ras Proteins
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6. Sakakura C, Nishio M, Miyagawa K, Miyashita A, Nagata H, Kin S, Fukuda K, Nakase Y, Hagiwara A, Nakanishi M, Yamazaki J, Yoshikawa S, Okamoto K, Kokuba Y, Otsuji E: Laparoscope-assisted superlow anterior resection combined with inter sphincteric rectal dissection for very low advanced rectal cancers combined with preoperative chemotherapy. Hepatogastroenterology; 2009 May-Jun;56(91-92):692-5
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  • [Title] Laparoscope-assisted superlow anterior resection combined with inter sphincteric rectal dissection for very low advanced rectal cancers combined with preoperative chemotherapy.
  • Transanal intersphincteric resection (ISR) has been increasingly used as a surgical treatment for extremely low rectal cancer.
  • The patient was a 46-year-old male with advanced rectal cancer on the lower rectum adjacent to the dentate line.
  • The patient refused abdomino-perineal resection (APR), so we performed laparoscope-assisted ISR after preoperative chemotherapy.
  • This patient showed favorable recovery including postoperative anal function with no complications or recurrent disease.
  • This procedure is feasible and has favorable short-term results for the radical treatment of very low rectal disease, while preserving anal function.
  • This operative procedure may be appropriate for locally advanced rectal cancers to avoid a permanent colostomy.
  • [MeSH-major] Adenocarcinoma / surgery. Anal Canal / surgery. Antineoplastic Agents / therapeutic use. Dissection / methods. Laparoscopy. Rectal Neoplasms / surgery

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  • (PMID = 19621682.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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7. Damascelli B, Cantù G, Mattavelli F, Tamplenizza P, Bidoli P, Leo E, Dosio F, Cerrotta AM, Di Tolla G, Frigerio LF, Garbagnati F, Lanocita R, Marchianò A, Patelli G, Spreafico C, Tichà V, Vespro V, Zunino F: Intraarterial chemotherapy with polyoxyethylated castor oil free paclitaxel, incorporated in albumin nanoparticles (ABI-007): Phase I study of patients with squamous cell carcinoma of the head and neck and anal canal: preliminary evidence of clinical activity. Cancer; 2001 Nov 15;92(10):2592-602
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  • [Title] Intraarterial chemotherapy with polyoxyethylated castor oil free paclitaxel, incorporated in albumin nanoparticles (ABI-007): Phase I study of patients with squamous cell carcinoma of the head and neck and anal canal: preliminary evidence of clinical activity.
  • BACKGROUND: This study was designed to determine the feasibility, maximum tolerated dose, and toxicities of intraarterial administration of paclitaxel-albumin nanoparticles in patients with advanced head and neck and recurrent anal canal squamous cell carcinoma.
  • METHODS: Forty-three patients (31 with advanced head and neck and 12 with recurrent anal canal squamous cell carcinoma) were treated intraarterially with ABI-007 every 4 weeks for 3 cycles.
  • In total, 120 treatment cycles were completed, 86 in patients with head and neck carcinoma (median, 3 cycles; range, 1-4) and 34 in patients with anal canal carcinoma (median, 3 cycles; range, 1-4).
  • In total, 120 transfemoral, percutaneous catheterization procedure-related complications occurred only during catheterization of the neck vessels in 3 patients (2 TIA, 1 hemiparesis) and resolved spontaneously.
  • [MeSH-major] Albumins / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / pharmacology. Anus Neoplasms / drug therapy. Carcinoma, Squamous Cell / drug therapy. Castor Oil / analogs & derivatives. Head and Neck Neoplasms / drug therapy. Paclitaxel / administration & dosage. Paclitaxel / pharmacology
  • [MeSH-minor] Adult. Aged. Chemistry, Pharmaceutical. Female. Humans. Infusions, Intra-Arterial. Male. Middle Aged. Neutropenia / chemically induced. Particle Size. Surface-Active Agents. Treatment Outcome

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  • [Copyright] Copyright 2001 American Cancer Society.
  • (PMID = 11745194.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Albumins; 0 / Antineoplastic Agents, Phytogenic; 0 / Surface-Active Agents; 61791-12-6 / polyethoxylated castor oil; 8001-79-4 / Castor Oil; P88XT4IS4D / Paclitaxel
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8. Handisurya A, Rieger A, Bago-Horvath Z, Schellenbacher C, Bankier A, Salat A, Stingl G, Kirnbauer R: Rapid progression of an anal Buschke-Lowenstein tumour into a metastasising squamous cell carcinoma in an HIV-infected patient. Sex Transm Infect; 2009 Aug;85(4):261-3
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  • [Title] Rapid progression of an anal Buschke-Lowenstein tumour into a metastasising squamous cell carcinoma in an HIV-infected patient.
  • BACKGROUND: Buschke-Löwenstein tumour (BLT) of the anogenitalia is a locally invasive, destructively growing verrucous carcinoma that does not metastasise.
  • Nevertheless, the tumour grows relentlessly and may rarely progress into squamous cell cancer (SCC).
  • RESULTS: A human immunodeficiency virus (HIV)-infected immunosuppressed patient developed (peri)anal warts accompanied by recurrent abscesses and fistulae.
  • Histology revealed condylomata acuminata, and low-risk genital human papillomavirus (HPV) type 11b was detected.
  • Whereas highly active antiretroviral therapy (HAART) effectively suppressed HIV replication, radiochemotherapy plus anti-EGFR antibody did not halt tumour progression, and the patient died from tumour-cachexia.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma, Squamous Cell / secondary. HIV Infections / complications. Immunocompromised Host
  • [MeSH-minor] Anal Canal / pathology. Anal Canal / virology. Anti-HIV Agents / therapeutic use. Cachexia / etiology. Fatal Outcome. Groin. HIV Seropositivity / drug therapy. Humans. Lymph Nodes / pathology. Male. Middle Aged. Neoplasm Invasiveness


9. Rousseau DL Jr, Petrelli NJ, Kahlenberg MS: Overview of anal cancer for the surgeon. Surg Oncol Clin N Am; 2004 Apr;13(2):249-62
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  • [Title] Overview of anal cancer for the surgeon.
  • Cancers of the anal canal represent a diverse group of pathology and require a multidisciplinary approach for treatment.
  • For the most common anal canal cancer, anal SCC, the primary therapy is CMT with systemic chemotherapy and radiation.
  • The surgeon plays a key role in the diagnosis and follow-up after treatment, with surgical intervention reserved for residual or recurrent disease.
  • For anal adenocarcinoma, aggressive surgical resection remains the mainstay of therapy, with radiation therapy and chemotherapy used to aid in local disease control and for treatment of metastatic disease.
  • The biggest improvements in survival for this disease will come with more effective systemic therapy.
  • [MeSH-major] Anus Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / secondary. Adenocarcinoma / surgery. Carcinoma, Squamous Cell / therapy. Combined Modality Therapy. Follow-Up Studies. Humans. Melanoma / secondary. Melanoma / surgery. Neoplasm Recurrence, Local / surgery. Neoplasm, Residual / surgery. Prognosis

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  • (PMID = 15137955.001).
  • [ISSN] 1055-3207
  • [Journal-full-title] Surgical oncology clinics of North America
  • [ISO-abbreviation] Surg. Oncol. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 95
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10. Mullen JT, Rodriguez-Bigas MA, Chang GJ, Barcenas CH, Crane CH, Skibber JM, Feig BW: Results of surgical salvage after failed chemoradiation therapy for epidermoid carcinoma of the anal canal. Ann Surg Oncol; 2007 Feb;14(2):478-83
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  • [Title] Results of surgical salvage after failed chemoradiation therapy for epidermoid carcinoma of the anal canal.
  • BACKGROUND: The standard treatment for epidermoid carcinoma of the anal canal consists of combined radiation and chemotherapy.
  • For patients who present with persistent or locally recurrent disease, salvage abdominoperineal resection is the treatment of choice.
  • METHODS: From 1990-2002, 31 patients underwent radical salvage surgery with curative intent after failure of initial sphincter-conserving therapy, and the medical records of these patients were retrospectively reviewed.
  • RESULTS: Eleven patients underwent radical salvage surgery for persistent disease and 20 patients for recurrent disease.
  • The median follow-up time was 29 months.
  • Twelve patients developed recurrent disease after radical salvage surgery.
  • Patients who received an initial radiation dose of less than 55 Gy had a significantly worse survival than those who received at least 55 Gy as part of their initial treatment (5-year overall survival 37.5% vs. 75%; age-adjusted hazard ratio 8.2 [95% CI: 1.1-59.8], P = .037).
  • Factors that were not found to have an impact on survival included the presence of persistent versus recurrent disease, tumor (T) stage, and margin status of resection.
  • CONCLUSIONS: Long-term survival following salvage surgery for persistent or locally recurrent epidermoid carcinoma of the anal canal can be achieved in the majority of patients.
  • However, patients who initially present with node-positive disease and patients who receive a radiation dose of less than 55 Gy as part of their initial chemoradiation therapy regimen have a worse prognosis after radical salvage surgery.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / surgery. Neoplasm, Residual / surgery
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colectomy. Female. Humans. Male. Middle Aged. Radiotherapy. Survival Analysis. Treatment Failure. Treatment Outcome

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  • (PMID = 17103253.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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11. Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS, Halverson AL: Squamous cell carcinoma of the anal canal: utilization and outcomes of recommended treatment in the United States. Ann Surg Oncol; 2008 Jul;15(7):1948-58
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  • [Title] Squamous cell carcinoma of the anal canal: utilization and outcomes of recommended treatment in the United States.
  • BACKGROUND: Over the past two decades, recommended treatment for squamous cell carcinoma of the anal canal has shifted from surgery to primary chemoradiation.
  • Resection is now reserved for persistent or recurrent disease.
  • Our objectives were (1) to evaluate treatment trends over the past 20 years, (2) to assess contemporary treatment utilization, and (3) to examine the impact of recommended vs nonguideline treatment on survival.
  • METHODS: From the National Cancer Data Base (1985-2005), 38,882 patients with anal canal cancer were identified.
  • Regression models were used to assess factors associated with use of nonguideline treatment (vs chemoradiation +/-surgery).
  • Univariate and multivariate methods were used to assess the impact of treatment on survival.
  • RESULTS: From 1985 to 2005, the use of chemoradiation increased significantly with a concomitant decrease in treatment with surgery alone (P < .0001).
  • However, only 74.9% (5014 of 6696) of patients underwent primary chemoradiation therapy in 2003-2005.
  • Overall, 22.7% (1523 of 6696) of patients received treatment that was not concordant with established guidelines: primary surgery (13.0%) and primary chemotherapy or radiation (9.7%).
  • Patients were significantly less likely to receive guideline treatment if male, older, black or Hispanic, more severe comorbidities, or Stage I (vs Stage II or III).
  • Patients undergoing chemoradiation ( +/- surgery) had higher 5-year survival rates than patients who received nonguideline treatment (64% vs 58%; hazard ratio 0.82, 95% confidence interval [95% CI] 0.77-0.87; P < .0001).
  • CONCLUSION: Primary chemoradiation therapy has supplanted surgical treatment and is associated with better outcomes; however, nearly a quarter of patients are still receiving treatment that is not concordant with established guidelines.
  • [MeSH-major] Anus Neoplasms / therapy. Neoplasms, Squamous Cell / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Female. Guideline Adherence. Humans. Male. Neoplasm Staging. Survival Rate. Treatment Outcome. United States

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  • (PMID = 18414951.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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12. Myint AS: The role of radiotherapy in the palliative treatment of gastrointestinal cancer. Eur J Gastroenterol Hepatol; 2000 Apr;12(4):381-90
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  • [Title] The role of radiotherapy in the palliative treatment of gastrointestinal cancer.
  • Gastrointestinal malignancy is the second commonest cancer and is associated with a high mortality.
  • Although definitive surgery could be offered for most tumour sites in the gastrointestinal tract, the majority of patients will still develop incurable recurrent or metastatic disease.
  • Radiotherapy has long been recognized as an effective palliative modality in gastrointestinal cancer.
  • The addition of chemotherapy to radiation has been used in most tumour sites in the gastrointestinal tract and has been shown to improve the therapeutic ratio; however, one should be aware of the increased toxicity and careful selection of patients is necessary.
  • This approach has led to improved local control in certain tumour sites, e.g. anal canal and oesophagus.
  • However, with increasing use of multi-modality therapy, increases in toxicity to the patient and in cost to healthcare providers must be taken into account.
  • [MeSH-minor] Anus Neoplasms / radiotherapy. Anus Neoplasms / therapy. Biliary Tract Neoplasms / radiotherapy. Biliary Tract Neoplasms / therapy. Brachytherapy. Colorectal Neoplasms / physiopathology. Colorectal Neoplasms / radiotherapy. Combined Modality Therapy. Esophageal Neoplasms / radiotherapy. Esophageal Neoplasms / therapy. Humans. Liver Neoplasms / radiotherapy. Liver Neoplasms / secondary. Pancreatic Neoplasms / radiotherapy. Pancreatic Neoplasms / therapy. Radiotherapy, High-Energy. Stomach Neoplasms / radiotherapy

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  • (PMID = 10783989.001).
  • [ISSN] 0954-691X
  • [Journal-full-title] European journal of gastroenterology & hepatology
  • [ISO-abbreviation] Eur J Gastroenterol Hepatol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] ENGLAND
  • [Number-of-references] 29
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13. You YN, Larson DW, Dozois EJ, Nelson H, Antpack Filho E, Klein K, Miller RC: Multimodality salvage therapy for anal cancer failing standard chemoradiation. J Clin Oncol; 2009 May 20;27(15_suppl):e15635

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multimodality salvage therapy for anal cancer failing standard chemoradiation.
  • : e15635 Background: Most squamous cell carcinomas of the anal canal (SCC) respond to chemoradiation, but effective therapy for locally-invasive(T4) or recurrent disease that fails standard chemoradiation and/or salvage abdominoperineal resection (APR) has not been clearly delineated.
  • A multimodality approach including chemoradiation, extended pelvic resection and intraoperative radiation therapy (IORT) was assessed for survival impact and treatment morbidity.morbidities.
  • METHODS: A prospective registry including 26 patients with locally-invasive or recurrent disease treated between 1993 and 2007 was reviewed.
  • All patients received chemotherapy and external beam radiation preoperatively, and 19% received additional postoperative chemoradiation.
  • Five-year OS were: 50%, 10%, and 22% for patients with locally-invasive, recurrent, and re-recurrent disease respectively.
  • CONCLUSIONS: For select patients with locally-persistent or recurrent SCC who fail standard primary treatment, a multimodality approach involving chemoradiation, extended pelvic resection and IORT offers a chance for improved survival.

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  • (PMID = 27962742.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Chrysos E, Athanasakis E, Vrekousis T, Almarashdah S, Fiorentini G, Xynos E, Zoras O: Abdominal and pelvic stop-flow chemotherapy. Effect of chemotherapeutic agents and tissue ischemia on rectoanal pressures. J Exp Clin Cancer Res; 2006 Sep;25(3):303-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Abdominal and pelvic stop-flow chemotherapy. Effect of chemotherapeutic agents and tissue ischemia on rectoanal pressures.
  • In hypoxic stop-flow chemoperfusion high doses of chemotherapeutic agents are almost directly administered to locally advanced tumors without risking significant systemic toxicity, although chemotherapy-induced neurotoxicity is still a problem.
  • The aim of the study was to assess rectoanal motility and sensation before, during and after abdominal and pelvic stop-flow chemotherapy using the methods of stationary and ambulatory manometry.
  • Stationary rectoanal manometry was performed within 24 hrs before and repeated 48 hrs after stop-flow chemotherapy in 7 consecutive patients with a history of locally advanced or recurrent abdominal and pelvic tumors.
  • Anal sphincter resting and squeeze pressures, rectal sensitivity, rectoanal inhibitory reflex and rectal volumes at which temporary and permanent urge to defecate were reported were examined.
  • Intraoperatively, changes in rectal and anal resting pressures before, during and after occlusion of the vessels and after administration of chemotherapeutic agent were as well recorded, analyzed and interpreted using ambulatory manometry.
  • Induction of anesthesia reduced distal and proximal anal resting pressures.
  • Intraoperative administration of chemotherapy did not further affect anal resting pressures during or after hypoxia.
  • Tissue hypoxia induced by vascular occlusion during stop-flow chemotherapy procedure, seems to be the only factor leading to a dramatic drop of anal pressures.
  • Anal pressures fully recover after reperfusion of the isolated area.
  • [MeSH-major] Abdominal Neoplasms / drug therapy. Anal Canal / drug effects. Antineoplastic Agents / pharmacokinetics. Chemotherapy, Cancer, Regional Perfusion / methods. Ischemia / pathology. Pelvic Neoplasms / drug therapy. Rectum / drug effects

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  • (PMID = 17167968.001).
  • [ISSN] 0392-9078
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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15. Nguyen WD, Mitchell KM, Beck DE: Risk factors associated with requiring a stoma for the management of anal cancer. Dis Colon Rectum; 2004 Jun;47(6):843-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Risk factors associated with requiring a stoma for the management of anal cancer.
  • PURPOSE: Combination chemotherapy and radiation therapy has become the standard of care for epidermoid carcinoma of the anus.
  • This treatment modality has allowed for preservation of the anus in most patients, sparing them the morbidity of a stoma.
  • METHODS: Data on all patients with epidermoid carcinoma of the anal canal who were treated with chemoradiation with curative intent at Ochsner Clinic Foundation were entered into a prospective registry.
  • We excluded four patients who were lost to follow-up and one patient who died during chemoradiation therapy.
  • The average radiation dose was 57 +/- 17 Gy.
  • CONCLUSIONS: Patients who have large tumors on presentation should be made aware of the possibility of requiring salvage surgery to treat persistent or recurrent disease.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Colostomy / methods. Neoplasm Recurrence, Local / surgery
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / adverse effects. Colectomy. Combined Modality Therapy. Digestive System Diseases / etiology. Digestive System Diseases / surgery. Female. Humans. Male. Middle Aged. Neoplasm Staging. Neoplasm, Residual. Radiotherapy / adverse effects. Risk Factors. Surgical Stomas. Wounds and Injuries / etiology. Wounds and Injuries / surgery

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  • (PMID = 15054683.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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16. Winburn GB: Anal carcinoma or "just hemorrhoids"? Am Surg; 2001 Nov;67(11):1048-58
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal carcinoma or "just hemorrhoids"?
  • Cancers of the anal margin and anal canal are extremely rare and often misdiagnosed.
  • From January 1985 through July 2000, 50 patients were diagnosed with anal cancer at two institutions.
  • This retrospective review includes all available cases of anal cancer including all histologies.
  • Patient charts were analyzed for diagnosis, staging, treatment, survival, and recurrence rate.
  • The pathologic diagnosis included 44 (88%) with squamous cell carcinoma, three (6%) with melanoma, two (4%) with adenocarcinoma, and one (2%) with Paget's disease.
  • Chemoradiotherapy was the primary treatment modality in 25 patients (50%).
  • Three patients (6%) received an APR as primary treatment, three (6%) in combination with chemoradiation, and four (8%) for salvage therapy.
  • Fourteen patients (28%) underwent wide local excision (WLE) as the primary treatment.
  • Two patients (4%) underwent WLE plus chemoradiation therapy.
  • One patient (2%) underwent WLE and chemotherapy.
  • Thirteen patients (26%) died of anal cancer; the average time to death from diagnosis was 13.2 months.
  • Thirty-two patients (64%) are alive, and 30 (60%) of these patients are free of disease (mean time since diagnosis 32.5 months, range 2-151 months).
  • Six patients (12%) had recurrence after treatment (mean time to recurrence 12.6 months; range 3-26 months).
  • Anal cancers continue to present at an advanced stage, with a high mortality rate.
  • Anal melanoma in particular is an aggressive and highly fatal cancer.
  • APR remains the recommended salvage therapy for advanced anal carcinomas that fail primary treatment.
  • Early recognition and detection of primary and recurrent disease is necessary for improved outcome.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma, Squamous Cell / diagnosis

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  • (PMID = 11730221.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Pizzocaro G, Algaba F, Horenblas S, Solsona E, Tana S, Van Der Poel H, Watkin NA, European Association of Urology (EAU) Guidelines Group on Penile Cancer: EAU penile cancer guidelines 2009. Eur Urol; 2010 Jun;57(6):1002-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] EAU penile cancer guidelines 2009.
  • CONTEXT: Squamous cell carcinoma (SCC) of the penis is a relatively rare but ominous disease.
  • EVIDENCE SYNTHESIS: More insight was gained into the etiology of SCC of the penis, together with improved staging and treatment: Human papillomavirus 16 plays an etiologic role in approximately 40-50% of cases.
  • Similarities in etiology with SCC of the head and neck, the female genitalia, and the anal canal have been found.
  • Improved diagnostics allowed earlier diagnosis, leading to more conservative treatments.
  • Adjuvant and neoadjuvant chemotherapy showed promising results in patients with advanced or recurrent disease.
  • Centralization of the disease contributed to standardization and rapid diffusion of new treatments with improved results and increased organ preservation.
  • [MeSH-major] Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / therapy. Penile Neoplasms / diagnosis. Penile Neoplasms / therapy. Quality of Life / psychology

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  • [Copyright] Copyright © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.
  • (PMID = 20163910.001).
  • [ISSN] 1873-7560
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Practice Guideline
  • [Publication-country] Switzerland
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18. Wanebo HJ, Belliveau J, Begossi G, Levy A: Isolated chemotherapeutic perfusion of the pelvis for advanced rectal cancer. Colorectal Dis; 2003 Sep;5(5):508-14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Isolated chemotherapeutic perfusion of the pelvis for advanced rectal cancer.
  • OBJECTIVE: Isolated pelvic perfusion exposes tissue to high doses of drug without the toxicity of high-dose systemic therapy and may benefit patients with advanced malignancy.
  • PATIENTS AND METHODS: There were 32 patients with locally advanced, previously irradiated cancer of the rectum and 5 patients with anal canal cancer.
  • RESULTS: Palliative perfusion in 15 patients with advanced rectal cancer resulted in symptomatic relief from 1 to 4 months in 11 of 14 with pelvic pain and limited benefit in 6 patients with mass, but no pain.
  • Pre-operative perfusion in 16 rectal cancer patients achieved a complete response (no tumour in pelvis) in 1 patient and significant tumour regression in 8 patients rendering them potentially resectable.
  • Three patients with recurrent epidermoid cancer had significant tumour regression and were resected with clear margins.
  • CONCLUSION: Isolated chemotherapeutic perfusion of the pelvis provides excellent palliation for patients with advanced or pelvic recurrence of rectal cancer or epidermoid cancer of anorectum and may potentiate resection in selected patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Rectal Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Catheterization. Chemotherapy, Cancer, Regional Perfusion. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycins / administration & dosage. Palliative Care. Pelvis. Preoperative Care. Treatment Outcome

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  • (PMID = 12925091.001).
  • [ISSN] 1462-8910
  • [Journal-full-title] Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • [ISO-abbreviation] Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Mitomycins; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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19. Shibata SI, Pezner R, Chu D, Doroshow JH, Chow WA, Leong LA, Margolin KA, McNamara MV, Morgan RJ Jr, Raschko JW, Somlo G, Tetef ML, Yen Y, Synold TW, Wagman L, Vora N, Carroll M, Lin S, Longmate J: A study of radiotherapy modalities combined with continuous 5-FU infusion for locally advanced gastrointestinal malignancies. Eur J Surg Oncol; 2004 Aug;30(6):650-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • AIM: We describe the feasibility of combining infusional 5-fluorouracil (5-FU) with intraoperative radiation therapy (IORT).
  • Patients without previous external beam radiation therapy (EBRT) were subsequently treated with EBRT (40-50Gy) concurrent with a 21-day continuous infusion of 5-FU.
  • Pancreatic, gastric, duodenal, ampullary, recurrent colorectal, and recurrent anal cancer were included.
  • RESULTS: During IORT/5-FU, no chemotherapy-related grade III or IV hematologic or gastrointestinal toxicity was noted.
  • One of nine patients who received post-operative radiation required a treatment break.
  • CONCLUSIONS: Treatment with a combination of IORT and 5-FU followed by EBRT and 5-FU is feasible.
  • However, long-term complications may be increased in previously irradiated recurrent pelvic tumours.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Agents / administration & dosage. Digestive System Surgical Procedures / methods. Fluorouracil / administration & dosage. Gastrointestinal Neoplasms / therapy. Radiotherapy / methods
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Feasibility Studies. Female. Humans. Infusions, Intravenous. Intraoperative Period. Male. Middle Aged. Pilot Projects. Radiotherapy, High-Energy. Treatment Outcome

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  • (PMID = 15256240.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; U3P01618RT / Fluorouracil
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20. Vorob'ev GI, Shelygin IuA, Nechushkin MI, Rybakov EG: [Results of surgical treatment of residual and recurrent anal tumors]. Khirurgiia (Mosk); 2008;(8):4-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Results of surgical treatment of residual and recurrent anal tumors].
  • Radio- or chemotherapy is a modern standard of anal cancer treatment.
  • The study is aimed to evaluate the role of abdominoperineal resection in the treatment of residual and recurrent anal cancer.
  • The radiotherapy delivered in a dose range of 55-65 Gy was used alone or in combination with chemotherapy with 5-fluoruracil, mitomycin C or Xeloda.
  • The complete tumor regression after radiotherapy/radiochemotherapy was achieved in 74(61.1%) of 120 patients with cancer-specific survival rate of 81.7%.
  • Thus, surgical treatment allowed secondary local tumor control in 76.9% of patients with the 5-year survival rates of 69.0%.
  • The median survival time for the non-operated patients, including those, received an extra course of radiotherapy, was 19 months.
  • Thus, abdominoperineal resection remains the method of choice in the treatment of residual and recurrent anal tumors.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Endosonography. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Russia / epidemiology. Survival Rate. Treatment Outcome

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  • (PMID = 18833142.001).
  • [ISSN] 0023-1207
  • [Journal-full-title] Khirurgiia
  • [ISO-abbreviation] Khirurgiia (Mosk)
  • [Language] rus
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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