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Anal cancer review

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https://www.readbyqxmd.com/read/28610935/prone-positioning-reduces-perineal-infections-when-performing-the-miles-procedure
#1
Anne M Dinaux, Ramzi Amri, David L Berger
BACKGROUND: Abdominoperineal resection (APR) remains the cornerstone treatment for rectal cancers less than 5 cm from the anal verge. The perineal portion of an APR can be done with the patient in lithotomy or repositioned to prone jack-knife position, which influences accessibility, visualization and ability to close the wound. This paper analyses the effect of patient positioning on perineal wound dehiscence and infections. METHODS: A retrospective review of all rectal cancer patients who underwent an APR at Massachusetts General Hospital between 2004 and 2014 (n = 149)...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28610905/anal-cancer-french-intergroup-clinical-practice-guidelines-for-diagnosis-treatment-and-follow-up
#2
REVIEW
Laurence Moureau-Zabotto, Veronique Vendrely, Laurent Abramowitz, Christophe Borg, Eric Francois, Diane Goere, Florence Huguet, Didier Peiffert, Laurent Siproudhis, Michel Ducreux, Olivier Bouché
INTRODUCTION: This document is a summary of the French Intergroup guidelines regarding the management of anal carcinomas, published in November 2016. METHODS: It is a collaborative work produced under the auspices of the majority of the French medical societies involved in the management of anal cancer. It is based on the previous guidelines published in 2010. Recommendations are graded in three categories, according to the amount of evidence found in the literature...
May 23, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28602545/what-is-the-impact-of-neoadjuvant-chemoradiation-on-outcomes-in-gastro-intestinal-cancer
#3
C Mariette, A Brouquet, D Tzanis, A Laurenzi, A de la Rochefordière, P Mariani, G Piessen, A Sa Cunha, C Penna
Multimodal therapeutic strategies combining chemotherapy, radiation therapy and surgery have been shown to be feasible and to have a positive impact on outcomes by decreasing the risk of locoregional recurrence and often by increasing overall survival. The advantages of neoadjuvant chemo(radio)therapy include optimal tumor control combined with better tolerance and compliance to treatment while also increasing the number of candidates for surgery. Whereas indications for neoadjuvant therapy are increasing, its impact on surgical treatment and postoperative outcomes are not well-known...
June 8, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28597183/discrepancies-between-nccn-and-esmo-guidelines-in-the-management-of-anal-cancer-a-qualitative-review
#4
REVIEW
Natalie Johnson, Gianluca Pellino, Constantinos Simillis, Shengyang Qiu, Stella Nikolaou, Daniel L Baird, Shahnawaz Rasheed, Paris P Tekkis, Christos Kontovounisios
There is an ever-growing need, with the ongoing developments in research and the progress towards patient centered care, to delineate standardized protocols of management of anal cancer. However, guidelines from different societies show some degree of disagreement. This is a systematic review of the literature to identify similarities and discrepancies between the guidelines for the management of anal cancer drafted by the European Society for Medical Oncology (ESMO) and by the National Comprehensive Cancer Network (NCCN)...
June 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28576183/radiotherapy-for-anal-cancer-intensity-modulated-radiotherapy-and-future-directions
#5
REVIEW
Serguei A Castaneda, Lindsay B Romak
The treatment of anal cancer has evolved remarkably in the past 30 years. Definitive chemoradiotherapy is the standard of care, allowing organ preservation and maintenance of continence for most patients. This article reviews recent advances in radiotherapy planning and delivery that have resulted in improvements in treatment-related toxicity. Most notably, the advent and wide adoption of intensity-modulated radiotherapy provides a superior toxicity profile compared with older techniques, while maintaining similar oncologic outcomes...
July 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28545552/hrhpv-e5-oncoprotein-immune-evasion-and-related-immunotherapies
#6
REVIEW
Antonio Carlos de Freitas, Talita Helena Araújo de Oliveira, Marconi Rego Barros, Aldo Venuti
The immune response is a key factor in the fight against HPV infection and related cancers, and thus, HPV is able to promote immune evasion through the expression of oncogenes. In particular, the E5 oncogene is responsible for modulation of several immune mechanisms, including antigen presentation and inflammatory pathways. Moreover, E5 was suggested as a promising therapeutic target, since there is still no effective medical therapy for the treatment of HPV-related pre-neoplasia and cancer. Indeed, several studies have shown good prospective for E5 immunotherapy, suggesting that it could be applied for the treatment of pre-cancerous lesions...
May 25, 2017: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/28533803/use-of-ultrasound-in-image-guided-high-dose-rate-brachytherapy-enumerations-and-arguments
#7
REVIEW
Susovan Banerjee, Tejinder Kataria, Deepak Gupta, Shikha Goyal, Shyam Singh Bisht, Trinanjan Basu, Ashu Abhishek
Inherently, brachytherapy is the most conformal radiotherapeutic technique. As an aid to brachytherapy, ultrasonography (USG) serves as a portable, inexpensive, and simple to use method allowing for accurate, reproducible, and adaptive treatments. Some newer brachytherapy planning systems have incorporated USG as the sole imaging modality. Ultrasonography has been successfully used to place applicator and dose planning for prostate, cervix, and anal canal cancers. It can guide placement of brachytherapy catheters for all other sites like breast, skin, and head and neck cancers...
April 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28530494/review-anal-intraepithelial-neoplasia-in-hiv-infected-men-who-have-sex-with-men-is-screening-and-treatment-justified
#8
Peter Wasserman, David S Rubin, Glenn Turett
Anal squamous cell carcinoma (SCC) is the fourth most prevalent cancer in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Human papillomavirus (HPV) has been detected in over 90% of anal carcinoma biopsy specimens from MSM, and is considered a necessary, but alone, insufficient factor for carcinogenesis. Anal intraepithelial neoplasia (AIN) may be precursive for SCC, and screening cytology with referral of persons with abnormality for high-resolution anoscopy-guided biopsy, and AIN treatment, has been recommended for prevention...
June 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28528686/hpv-entry-into-cells
#9
REVIEW
Pinar Aksoy, Elinor Y Gottschalk, Patricio I Meneses
Human papillomavirus (HPV) is a sexually transmitted virus responsible for the development of cervical cancer, anal cancer, head and throat cancers, as well as genital area warts. A major focus of current HPV research is on preventing the virus from entering a cell and transferring its genetic material to the nucleus, thus potentially preventing the development of cancer. Although the available HPV vaccines are extremely successful, approximately 15 additional cancer-causing HPVs have been identified that the vaccines do not protect against...
April 2017: Mutation Research
https://www.readbyqxmd.com/read/28527628/multidisciplinary-clinics-for-colorectal-cancer-care-reduces-treatment-time
#10
Vanessa N Kozak, Alok A Khorana, Sudha Amarnath, Katherine E Glass, Matthew F Kalady
INTRODUCTION: Management of locally advanced and metastatic colorectal cancer (CRC) requires the expertise of multiple specialists. Multidisciplinary clinics (MDCs) are a working model designed to facilitate delivery of coordinated care. The present study evaluated the effects of MDC on the time to treatment (TTT). PATIENTS AND METHODS: Patients with CRC or locally advanced anal cancer who were evaluated at a single-institution MDC from January 2014 to October 2015 were identified from an institutional registry...
April 19, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28503516/transanal-minimally-invasive-surgery-for-treating-patients-with-regressed-rectal-cancer-after-preoperative-chemoradiotherapy
#11
Byoung Chul Lee, Seonok Oh, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
PURPOSE: Although the standard treatment for patients with locally advanced rectal cancer managed by preoperative chemoradiotherapy (CRT) is a radical resection, local excisions are used in highly-selective cases. Recently, transanal minimally-invasive surgery (TAMIS) has emerged as a feasible technique for local excision of midrectal lesions. We assess the feasibility of using TAMIS to treat patients with locally advanced rectal cancer who showed good response to CRT. METHODS: From October 2010 to June 2013, 35 consecutive patients with rectal cancer managed by using preoperative CRT underwent TAMIS...
April 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28501560/the-immune-microenvironment-and-hpv-in-anal-cancer-rationale-to-complement-chemoradiation-with-immunotherapy
#12
REVIEW
Daniel Martin, Franz Rödel, Panagiotis Balermpas, Claus Rödel, Emmanouil Fokas
Anal squamous cell carcinomas (ASCC) are increasing in frequency across the developed world, and 70-90% of all cases originate from infection with human papilloma viruses (HPV). Primary chemoradiotherapy (CRT) is the standard treatment for ASCC, but local and/or distant failure still occurs in up to 30% of patients. HPV-associated ASCC and tumors with a higher density of tumor infiltrating lymphocytes (TIL) carry a better prognosis. Furthermore, HPV can render tumors more immunogenic, whereas it correlates with elevated TIL densities...
May 10, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28493146/laparoscopic-proximal-gastrectomy-with-oblique-jejunogastrostomy
#13
Kimitaka Tanaka, Yuma Ebihara, Yo Kurashima, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Soichi Murakami, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: Proximal early gastric cancer is a good indication for totally laparoscopic proximal gastrectomy (TLPG) with double-tract reconstruction (DTR). However, when most of the dietary intake passes through the escape route of the jejunum, the functional benefits of proximal gastrectomy might be similar to those after total gastrectomy. Our DTR procedure was improved for easy passage through the remnant stomach. The purposes of this study were to present a novel technique for intracorporeal DTR using linear staplers after TLPG and to investigate surgical outcomes...
May 10, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28463160/predictors-of-radiation-therapy-related-gastrointestinal-toxicity-from-anal-cancer-dose-painted-intensity-modulated-radiation-therapy-secondary-analysis-of-nrg-oncology-rtog-0529
#14
Jeffrey R Olsen, Jennifer Moughan, Robert Myerson, Andre Abitbol, Desiree E Doncals, Douglas Johnson, Tracey E Schefter, Yuhchyau Chen, Barbara Fisher, Jeff Michalski, Samir Narayan, Albert Chang, Christopher H Crane, Lisa Kachnic
PURPOSE: NRG Oncology RTOG 0529 assessed the feasibility of dose-painted intensity modulated radiation therapy (DP-IMRT) to reduce the acute morbidity of chemoradiation with 5-fluorouracil (5FU) and mitomycin-C (MMC) for T2-4N0-3M0 anal cancer. This secondary analysis was performed to identify patient and treatment factors associated with acute and late gastrointestinal (GI) adverse events (AEs). METHODS AND MATERIALS: NRG Oncology RTOG 0529 treatment plans were reviewed to extract dose-volume data for tightly contoured small bowel, loosely contoured anterior pelvic contents (APC), and uninvolved colon outside the target volume (UC)...
June 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28432678/anal-metastasis-of-rectal-cancer-adenocarcinoma-of-squamous-cells-a-case-report-and-literature-review
#15
Shun Sasaki, Masahiko Sugiyama, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Hiroshi Saeki, Eiji Oki, Yoshinao Oda, Yoshihiko Maehara
Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28395054/anal-high-grade-squamous-intraepithelial-lesions-in-human-immunodeficiency-virus-infected-men-a-study-of-100-cases-with-emphasis-on-cytohistologic-correlation
#16
Yuxin Liu, Xiaofei Wang, Tamara Kalir, David Chhieng, Keith Sigel, Michael M Gaisa
Objectives: Anorectal cytology (ARC) is a widely used screening tool for anal cancer in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Its diagnostic accuracy needs to be improved, especially for high-grade squamous intraepithelial lesions (HSILs). Methods: Using 100 HIV+ MSM with biopsy-proven anal HSILs, we correlated histologic/cytologic findings. Results: Upon review, HSIL cells were present in 58 cytology samples and absent in 42...
March 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28379306/anal-neoplasia-in-inflammatory-bowel-disease-classification-proposal-epidemiology-carcinogenesis-and-risk-management-perspectives
#17
Andrew Wisniewski, Jean-Francois Fléjou, Laurent Siproudhis, Laurent Abramowitz, Magali Svrcek, Laurent Beaugerie
Patients with inflammatory bowel disease [IBD] may develop, similarly to individuals from general population, rare cases of human papilloma virus [HPV]-related anal canal squamous cell carcinoma [SCC] and intra-epithelial precursor lesions, as well as very rare cases of anal canal adenocarcinoma. Patients with chronic perianal Crohn's disease [CD] are at substantial risk of developing SCC or adenocarcinoma from the fistula-lining epithelium, as well as SCC or adenocarcinoma arising from chronic anorectal ulcerations or strictures...
March 30, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28374259/anorectal-complications-after-robotic-intersphincteric-resection-for-low-rectal-cancer
#18
Li-Jen Kuo, James Chi-Yong Ngu, Yan-Jiun Huang, Yen-Kuang Lin, Chia-Che Chen, Yiu-Shun Tong, Szu-Chia Huang, Chia-Chen Hu, Shu-Hwa Tan
BACKGROUND: Robotic intersphincteric resection (ISR) has been introduced for sphincter-preservation in the treatment of low rectal cancer. However, many patients experience anorectal symptoms and defecatory dysfunction after ISR. This study aims to evaluate the anorectal complications that develop after ISR. METHODS: The medical records of 108 patients who underwent robotic ISR at Taipei Medical University Hospital, Taipei, Taiwan between December 2011 and June 2016 were retrospectively reviewed...
April 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28368260/clinical-endpoints-in-trials-of-chemoradiation-for-patients-with-anal-cancer
#19
REVIEW
Robert Glynne-Jones, Richard Adams, Andre Lopes, Helen Meadows
This Review examines the reporting of endpoints in randomised controlled trials (RCTs) of radical chemoradiation for treatment of squamous cell carcinoma of the anus. The types, frequency, and definitions of clinical primary and secondary endpoints, and patient-reported outcome measures, reported in the methods and results sections of papers (and protocols, if available) were examined. Only six published RCTs comprising 2877 patients were identified. Primary outcome measures varied across the trials analysed: two used disease-free survival, one used progression-free survival, two used local failure, and one used colostomy-free survival...
April 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28353363/does-chronomodulated-radiotherapy-improve-pathological-response-in-locally-advanced-rectal-cancer
#20
Tim Squire, Grant Buchanan, David Rangiah, Ian Davis, Desmond Yip, Yu Jo Chua, Tyvin Rich, Hany Elsaleh
The predominant mode of radiation-induced cell death for solid tumours is mitotic catastrophe, which is in part dependent on sublethal damage repair being complete at around 6 h. Circadian variation appears to play a role in normal cellular division, and this could influence tumour response of radiation treatment depending on the time of treatment delivery. We tested the hypothesis that radiation treatment later in the day may improve tumour response and nodal downstaging in rectal cancer patients treated neoadjuvantly with radiation therapy...
2017: Chronobiology International
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