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1. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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2. 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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  • 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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3. Winburn GB: Anal carcinoma or "just hemorrhoids"? Am Surg; 2001 Nov;67(11):1048-58
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  • [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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4. 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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5. 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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6. Hill J, Meadows H, Haboubi N, Talbot IC, Northover JM: Pathological staging of epidermoid anal carcinoma for the new era. Colorectal Dis; 2003 May;5(3):206-13
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  • [Title] Pathological staging of epidermoid anal carcinoma for the new era.
  • Chemoradiotherapy is the standard treatment for most patients with epidermoid anal cancer.
  • Pre-treatment staging is based on size for T1-T3 lesions and clinical and radiological assessment of adjacent organ invasion for T4 lesions.
  • For patients with residual or recurrent carcinoma, anorectal excision offers the best chance of oncological salvage.
  • Pathological staging systems for anorectal excision specimens were validated at the time when surgical treatment was first line therapy.
  • A validated staging system is necessary for salvage surgical excision specimens following an attempt to cure by radiotherapy and chemotherapy for the purpose of prognosis and further treatment planning.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. Neoplasm Staging / standards

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  • (PMID = 12780879.001).
  • [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; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Number-of-references] 51
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7. Zoucas E, Frederiksen S, Lydrup ML, Månsson W, Gustafson P, Alberius P: Pelvic exenteration for advanced and recurrent malignancy. World J Surg; 2010 Sep;34(9):2177-84
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  • [Title] Pelvic exenteration for advanced and recurrent malignancy.
  • BACKGROUND: Improved surgical techniques and oncological treatment render many advanced pelvic tumors amenable to curative resection.
  • METHODS: From January 2003 to November 2008, 85 patients underwent multivisceral pelvic resection; 87% had colorectal or anal malignancies.
  • Fifty-eight percent received preoperative chemotherapy and pelvic irradiation.
  • Twenty-seven manifested disseminated disease without local recurrence, two developed isolated local recurrence, and six had local and systemic recurrences.
  • Survival was correlated with clear margins and time to relapse.
  • Thorough patient selection and multimodal therapy are necessary to attain maximum benefit.
  • [MeSH-major] Anus Neoplasms / surgery. Colorectal Neoplasms / surgery. Neoplasm Recurrence, Local / surgery. Pelvic Exenteration

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  • (PMID = 20512493.001).
  • [ISSN] 1432-2323
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. van der Wal BC, Cleffken BI, Gulec B, Kaufman HS, Choti MA: Results of salvage abdominoperineal resection for recurrent anal carcinoma following combined chemoradiation therapy. J Gastrointest Surg; 2001 Jul-Aug;5(4):383-7
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  • [Title] Results of salvage abdominoperineal resection for recurrent anal carcinoma following combined chemoradiation therapy.
  • Combined chemotherapy and radiation therapy is the standard treatment for epidermoid carcinoma of the anal canal.
  • The aim of this study was to review our experience with abdominoperineal resection following failure of chemoradiation therapy for epidermoid carcinoma of the anus.
  • Between 1980 and 1998, 17 patients underwent salvage abdominoperineal resection following failure of chemoradiation therapy.
  • Twelve patients underwent abdominoperineal resection for persistent disease and five patients for recurrent disease.
  • The median follow-up time for the patients operated on with curative intent was 53 months.
  • Selected patients with recurrent or persistent anal carcinoma following chemoradiation therapy can be offered salvage abdominoperineal resection.
  • Prolonged survival can be achieved in some patients following salvage resection for epidermoid carcinoma of the anal canal.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Neoplasm Recurrence, Local / surgery
  • [MeSH-minor] Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Postoperative Complications / epidemiology. Reconstructive Surgical Procedures. Salvage Therapy. Surgical Flaps. Survival Analysis. Time Factors. Treatment Failure. Treatment Outcome

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  • (PMID = 11985979.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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


11. Wieder R, Pavlick AC, Bryan M, Hameed M, Baredes S, Pliner L, Saunders T, Korah R: Phase I/II trial of accutane as a potentiator of carboplatin and paclitaxel in squamous cell carcinomas. Am J Clin Oncol; 2002 Oct;25(5):447-50
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  • This study investigated the toxicity and efficacy of a 13-cis retinoic acid, carboplatin, and paclitaxel (Taxol) regimen in 18 patients with recurrent or metastatic squamous cell carcinomas (12 head and neck, 4 cervix, 1 esophagus, and 1 anus).
  • Fifteen evaluable patients had a total of 72 treatment cycles.
  • There were 21 grade III or IV toxicities distributed among all the dose levels, including neutropenia, anemia, thrombocytopenia, elevated prothrombin time/partial thromboplastin time, elevated alkaline phosphatase, weight loss, alopecia, and three deaths from aspiration pneumonia and septic shock.
  • The three partial responses were in the four patients with cervical cancer.
  • Toxicity profiles and overall response rates were comparable to prior studies with similar chemotherapy regimens alone.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Isotretinoin / therapeutic use
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Drug Synergism. Female. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / pathology. Humans. Male. Middle Aged. Paclitaxel / administration & dosage. Remission Induction. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / pathology

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  • (PMID = 12393981.001).
  • [ISSN] 0277-3732
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; EH28UP18IF / Isotretinoin; P88XT4IS4D / Paclitaxel
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12. 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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13. 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


14. Szilagy EJ, Farid A: Anal Carcinoma. Curr Treat Options Gastroenterol; 2001 Jun;4(3):275-279
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  • [Title] Anal Carcinoma.
  • Carcinoma of the anus is a rare malignancy that usually is diagnosed at an advanced stage, in spite of being easily visible and accessible.
  • Its treatment has evolved from being mainly surgical to one consisting of chemotherapy (with fluorouracil and mitomycin) and radiation (megavoltage linear accelerator therapy delivering between 40 to 50 Gy).
  • Local surgical excision is most often performed for either carcinoma in situ or microinvasive lesions of the anal margin.
  • Radical resection is indicated for patients with residual disease following chemoradiation or for recurrent disease.

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  • (PMID = 11469985.001).
  • [ISSN] 1092-8472
  • [Journal-full-title] Current treatment options in gastroenterology
  • [ISO-abbreviation] Curr Treat Options Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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


16. Chao C, Goldberg M, Hoffman JP: Surgical salvage therapy: abdominoperineal resection for recurrent anal carcinoma, metastasectomy of recurrent colorectal cancer, and esophagectomy after combined chemoradiation. Curr Opin Oncol; 2000 Jul;12(4):353-6
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  • [Title] Surgical salvage therapy: abdominoperineal resection for recurrent anal carcinoma, metastasectomy of recurrent colorectal cancer, and esophagectomy after combined chemoradiation.
  • This review highlights the advances in the salvage surgical therapies for recurrent disease after definitive therapy of anal carcinoma, colorectal cancer, including liver metastasectomy, and esophageal carcinoma treated primarily with chemoradiation.
  • New diagnostic modalities, advances in neoadjuvant therapies for unresectable liver metastases, and, in addition, the importance of adjuvant hepatic arterial chemotherapy after curative liver resections are reviewed.
  • Although chemoradiation is not the standard of care for esophageal cancer, salvage esophagectomy after such treatment is discussed.
  • Definitive chemoradiation for squamous cell carcinoma of the anus has altered the role of surgical intervention to a salvage option instead of primary treatment.
  • Although this is not yet the case for esophageal carcinoma, recent improved chemoradiation regimens have been reported by the French and Japanese, who use surgery for nonresponders.
  • For recurrent colorectal carcinoma, including liver-only metastases, patients can be rendered disease free after surgical extirpation with evidence of improved survival.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy. Neoplasm Recurrence, Local / therapy. Rectal Neoplasms / therapy. Salvage Therapy
  • [MeSH-minor] Abdomen / surgery. Chemotherapy, Adjuvant. Colorectal Neoplasms / pathology. Colorectal Neoplasms / therapy. Humans. Liver Neoplasms / pathology. Liver Neoplasms / therapy. Perineum / surgery. Radiotherapy, Adjuvant

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  • (PMID = 10888421.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 26
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18. 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
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  • [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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19. Vietharsdóttir H, Moeller PH, Jóhannsson J, Jónasson JG: [Anal cancer in Iceland 1987-2003. A population based study]. Laeknabladid; 2006 May;92(5):365-72
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  • [Title] [Anal cancer in Iceland 1987-2003. A population based study].
  • [Transliterated title] Carcinoma ani á Islandi 1987-2003 -- lýethgrundueth rannsókn.
  • OBJECTIVE: Anal cancer is a rare disease.
  • The aim of this study was to describe anal cancer in Iceland in 1987-2003 with respect to incidence, histologic type, treatment, recurrence rate and survival.
  • MATERIAL AND METHODS: This is a retrospective study in which all malignant anal tumours diagnosed in Iceland in the period 1987-2003 were reviewed with respect to patient outcome.
  • This is a nationwide, population-based study of malignant tumours of the anal region.
  • RESULTS: From 1987-2003 thirty-eight patients were diagnosed with anal cancer, 28 females and 10 males.
  • Age standardized incidence rates for anal cancer in Iceland were 0.3 (+/-0.2) of 100.000 males and 0.9 (+/-0.4) of 100.000 females.
  • Most patients had squamous cell carcinoma (n=30).
  • The remaining histologic types were malignant melanoma (n=3), adenosquamous carcinoma (n=1), adenocarcinoma (n=1), GIST (n=1) and undifferentiated carcinoma (n=2).
  • Treatment modalities used were chemotherapy (n=12), radiotherapy (n=25) and local excision (n=18) and/or APR (n=5).
  • One patient received no treatment.
  • Many patients were treated with more than one treatment modality (n=18).
  • Twelve patients had recurrent cancer.
  • The mean value of the time from diagnosis of the primary to the recurrent cancer was 15.6 months (range, 5.9-117).
  • Sixteen patients remain with disease and ten have died of anal cancer.
  • The five year survival rate for patients diagnosed in the years 1987 to 1998 is 75% but cancer-specific survival is 82%.
  • CONCLUSION: Age-standardized incidence for anal cancer in Iceland is similar to other regions.
  • The proportion of adenocarcinoma of the anus is lower in Iceland than elsewhere.
  • [MeSH-major] Anus Neoplasms / epidemiology
  • [MeSH-minor] Adenocarcinoma / epidemiology. Aged. Carcinoma / epidemiology. Carcinoma, Adenosquamous / epidemiology. Carcinoma, Squamous Cell / epidemiology. Defecation. Female. Gastrointestinal Hemorrhage / etiology. Humans. Iceland / epidemiology. Incidence. Male. Melanoma / epidemiology. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Pain / etiology. Pruritus / epidemiology. Retrospective Studies. Survival Analysis

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  • (PMID = 16741319.001).
  • [ISSN] 0023-7213
  • [Journal-full-title] Læknablađiđ
  • [ISO-abbreviation] Laeknabladid
  • [Language] ice
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Iceland
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20. 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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  • [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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21. Sasaki S, Kojima T, Hidemura A, Hatanaka K, Uekusa T, Ishimaru M: [A case report of anorectal malignant melanoma showing a complete response after DTIC/ACNU/VCR therapy]. Gan To Kagaku Ryoho; 2010 Oct;37(10):1999-2002
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  • [Title] [A case report of anorectal malignant melanoma showing a complete response after DTIC/ACNU/VCR therapy].
  • Cancer cells were found in regional lymph nodes.
  • Post-operative CT scan demonstrated multiple metastases in the liver, and he received two courses of combined chemotherapy, DAV regimen (dacarbazine: DTIC 100 mg iv days 1-5, nimustine hydrochloride: ACNU 100 mg iv day 1, vincristine sulfate: VCR 1 mg iv day 1), leading to a complete response.
  • However, malignant melanoma cells were found in hernia contents at the operation for left inguinal hernia, which led to a diagnosis of recurrent malignant melanoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Dacarbazine / therapeutic use. Melanoma / drug therapy. Nimustine / therapeutic use. Vincristine / therapeutic use
  • [MeSH-minor] Combined Modality Therapy. Humans. Liver Neoplasms / drug therapy. Liver Neoplasms / radiography. Liver Neoplasms / secondary. Male. Middle Aged. Remission Induction. Tomography, X-Ray Computed

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  • (PMID = 20948273.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0S726V972K / Nimustine; 5J49Q6B70F / Vincristine; 7GR28W0FJI / Dacarbazine
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