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Anal cancer recurrence

Eleanor M Osborne, Cathy Eng, John M Skibber, Miguel A Rodriguez-Bigas, George J Chang, Yi-Qian Nancy You, Brian K Bednarski, Bruce D Minsky, Marc E Delclos, Eugene Koay, Sunil Krishnan, Christopher H Crane, Prajnan Das
OBJECTIVES: Although chemoradiation is the standard of care for anal cancer, limited data exist regarding pelvic reirradiation (re-RT) for recurrent disease. We investigated toxicity and outcomes in patients who received prior pelvic radiation therapy (RT), and subsequently underwent hyperfractionated accelerated re-RT to the pelvis for recurrent anal cancer. MATERIALS AND METHODS: We reviewed records of 10 patients with recurrent anal squamous cell carcinoma who previously received pelvic RT to at least 30 Gy as a component of their chemoradiation and underwent re-RT in 1...
October 17, 2016: American Journal of Clinical Oncology
Vanessa Verdin, Joseph Weerts, David Francart, Constant Jehaes, David Magis, Paul Magotteaux, Laurine Mattart, Benoit Monami, Christian Wahlen, Serge Markiewicz
BACKGROUND: Rectal adenocarcinomas surgery morbidity and mortality might be impaired by neoadjuvant therapy. We performed this retropsective study to be compared with the PROCARE study running afterwards. METHODS: We performed a retrospective study of 95 patients operated on for rectal adenocarcinoma in a single institution during the period of 2007-2009. We used logistic regression to estimate the relationship between possible predictive parameters of anastomotic leakage (AL)...
October 17, 2016: Acta Chirurgica Belgica
Young Seob Shin, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Tae Won Kim, Heung Moon Chang, Jin-Hong Park, Seung Do Ahn, Sang-Wook Lee, Eun Kyung Choi, Jin Cheon Kim, Jong Hoon Kim
PURPOSE: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. MATERIALS AND METHODS: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months...
September 2016: Radiation Oncology Journal
Thomas Gryc, Oliver Ott, Florian Putz, Stefan Knippen, Dimitrios Raptis, Rainer Fietkau, Vratislav Strnad
PURPOSE: To analyze the efficacy of a protocol-based brachytherapy (BT) boost after external beam radiation therapy (EBRT) with simultaneous chemotherapy in patients with anal carcinoma. METHODS AND MATERIALS: About 190 patients have been analyzed. Around 143 patients were identified with a good clinical response at the end of EBRT. Another 47 patients received an additional BT boost to the residual tumor at 6 weeks after end of chemoradiation. RESULTS: The 5-year incidence of local recurrence was 24% in patients with BT boost and 19% in patients without BT boost (p = 0...
October 3, 2016: Brachytherapy
Naohito Beppu, Fumihiko Kimura, Tsukasa Aihara, Hiroshi Doi, Naohiro Tomita, Hidenori Yanagi, Naoki Yamanaka
BACKGROUND: Short-course radiotherapy with delayed surgery (SRT-delay) is still under clinical investigation for its efficacy in treating low rectal cancer (≤5 cm from the anal verge). This study was designed to assess the pattern of local recurrence and oncologic outcomes in T3 low rectal cancer treated with SRT-delay. METHODS: This study enrolled T3 low rectal cancer patients without distant metastasis between 2003 and 2015. All patients received total mesorectal excision following SRT-delay (25 Gy/10 fractions/5 days + S-1 radiosensitizer with a 4-week delay of surgery)...
October 3, 2016: Annals of Surgical Oncology
Alessandro Sturiale, Jacopo Martellucci, Letizia Zurli, Carla Vaccaro, Luigi Brusciano, Paolo Limongelli, Ludovico Docimo, Andrea Valeri
PURPOSE: This is a retrospective analysis including all of the patients that have undergone anterior resection for rectal cancer from January 1998 to December 2005 in two tertiary referral centers. The study aims to evaluate the long term functional results after low anterior resection and to identify the risk factors of postoperative bowel disorders. METHOD: Data were collected from the clinical records, and then the low anterior resection syndrome score which is a specific questionnaire to investigate the symptoms after surgery was submitted to the selected patients...
September 30, 2016: International Journal of Colorectal Disease
Hans-Christian Pommergaard, Jakob Burcharth, Jacob Rosenberg, Hans Raskov
PURPOSE: Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible association between occurrence of sporadic advanced adenomas with location and age. MATERIALS AND METHODS: A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed...
August 16, 2016: Scandinavian Journal of Gastroenterology
E M Osborne, C Eng, J Skibber, M Rodriguez-Bigas, G Chang, Y N You, B Bednarski, B D Minsky, M E Delclos, E J Koay, S Krishnan, C H Crane, P Das
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Paul C Mayor, Shashikant Lele
Photodynamic therapy (PDT) is a treatment modality used in the management of solid tumor malignancies that employs the use of a photosensitizing agent, a light source and oxygen in order to illicit a direct cytotoxic effect. Its use in gynecologic malignancies is somewhat novel and has been used for palliative and curative intent. At the Roswell Park Cancer Institute, the use of PDT in the management of gynecologic cancers began in the mid 1980s and since that time 35 patients have received PDT as a treatment for recurrent or metastatic cutaneous and vulvar, vaginal, anal, and cervical recurrences...
2016: Cancers
Sigmar Stelzner, Gunter Hellmich, Anja Sims, Thomas Kittner, Eric Puffer, Joerg Zimmer, Dorothea Bleyl, Helmut Witzigmann
PURPOSE: Extralevator abdominoperineal excision (ELAPE) was introduced to improve outcomes for low-lying locally advanced rectal cancers (LARC) not amenable to sphincter preserving procedures. This study investigates prospectively outcomes of patients operated on with ELAPE compared with a similar cohort of patients operated on with conventional APE. METHODS: After the exclusion of patients without neoadjuvant therapy, in-hospital mortality, and incomplete metastatectomy, we identified 72 consecutive patients who had undergone either conventional APE (n = 36) or ELAPE (n = 36) for LARC ≤6 cm from the anal verge...
October 2016: International Journal of Colorectal Disease
A Chau, M Frasson, C Debove, L Maggiori, Y Panis
BACKGROUND: There are no published data concerning management of patients with exteriorized colonic prolapse (CP) after intersphincteric rectal resection (ISR) and side-to-end coloanal manual anastomosis (CAA) for very low rectal cancer. The aim of the present study was to report our experience in 12 consecutive cases of CP following ISR with CAA. METHODS: From 2006 to 2014, all patients with very low rectal cancer who developed CP after ISR and CAA were reviewed...
October 2016: Techniques in Coloproctology
Chien-Hsin Chen, Po-Li Wei, Mao-Chih Hsieh, En-Kwang Lin, Jeng-Fong Chiou, Yen-Jung Lu, Szu-Yuan Wu
To investigate the outcomes of the selective neoadjuvant concurrent chemoradiotherapy (CCRT) in lower 3rd rectal cancer patients in different groups (with or without neoadjuvant CCRT), especially in survival rate, local recurrence rate, and sphincter preservation rate.From January 1999 to December 2012, 69 consecutive patients who had histologically proven adenocarcinoma of lower 3rd rectum, defined preoperatively as lower tumor margin within 7 cm from the anal verge as measured by rigid sigmoidoscopy, received total mesorectum excision (TME)...
September 2016: Medicine (Baltimore)
Christos Kontovounisios, Emile Tan, Nikhil Pawa, Gina Brown, Diana Tait, David Cunningham, Shahnawaz Rasheed, Paris Tekkis
AIM: There is wide disparity in the care of patients with multi-visceral involvement of rectal cancer. The results of treatment of advanced and recurrent colorectal cancer are presented from a centre where a dedicated Multidisciplinary Team (MDT) is central to the management. METHOD: All consecutive MDT referrals between 2010 and 2014 were examined. Analysis was undertaken of the referral pathway, site, selection process, management decision, R0 resection rate, mortality / morbidity / Clavien-Dindo (CD) classification of morbidity, length of stay (LOS), and improvement of quality of life...
September 15, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Daniela Rega, Biagio Pecori, Dario Scala, Antonio Avallone, Ugo Pace, Antonella Petrillo, Luigi Aloj, Fabiana Tatangelo, Paolo Delrio
PURPOSE: Neoadjuvant therapy is able to reduce local recurrence in rectal cancer. Immediate surgery after short course radiotherapy allows only for minimal downstaging. We investigated the effect of delayed surgery after short-course radiotherapy at different time intervals before surgery, in patients affected by rectal cancer. METHODS: From January 2003 to December 2013 sixty-seven patients with the following characteristics have been selected: clinical (c) stage T3N0 ≤ 12 cm from the anal verge and with circumferential resection margin > 5 mm (by magnetic resonance imaging); cT2, any N, < 5 cm from anal verge; and patients facing tumors with enlarged nodes and/or CRM+ve who resulted unfit for chemo-radiation, were also included...
2016: PloS One
Silvia Quaresima, Andrea Balla, Luana Franceschilli, Marco La Torre, Corrado Iafrate, Mostafa Shalaby, Nicola Di Lorenzo, Pierpaolo Sileri
BACKGROUND AND OBJECTIVES: Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to transanal endoscopic microsurgery (TEM). The authors report their experience with TAMIS for the treatment of mid and high rectal tumors. METHODS: From November 2011 through May 2016, 31 patients (21 females, 68%), with a median age of 65 years who underwent single-port TAMIS were prospectively enrolled. Mean distance from the anal verge of the rectal tumors was 9...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Myriam Wartski
The existing recommendations for fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) use in digestive cancers (excluding neuroendocrine tumours) are summarized in the present article. FDG-PET/CT is nowadays a routine imaging modality for digestive malignancies and its use is currently increasing. FDG-PET/CT is considered to be a crucial tool in pretherapeutic assessment of esophageal, localized pancreatic and anal cancer. It represents a key exam in suspicion of recurrence of colorectal cancer in case of elevated serum tumor markers...
September 2016: La Presse Médicale
Xuetong Jiang, Chuanqi Xu, Dong Tang, Daorong Wang
Synchronous colorectal cancers refer to the simultaneous occurrence of multiple colorectal tumors in a single patient, excluding any metastases from other organs. At present, radical surgery is considered the standard curative treatment; however, individualized surgical strategies depend on tumor location, the depth of invasion and the general health of the patient. In the present study, the case of a 52-year-old man who presented with a 2-month history of abdominal pain that was accompanied by intermittent hematochezia and weight loss is reported...
August 2016: Oncology Letters
Hilary P Bagshaw, William T Sause, Ute Gawlick, H Tae Kim, Jonathan Whisenant, George M Cannon
OBJECTIVES: The objective is to determine localregional control (LRC), distant metastasis free survival, disease-free survival, overall survival (OS), and toxicity for patients with squamous cell carcinoma of the anus treated with definitive chemotherapy and intensity-modulated radiation therapy (IMRT). MATERIALS AND METHODS: We conducted a retrospective review of patients treated using IMRT for squamous cell carcinoma of the anus at our institution since 2005. Patients with local recurrences were identified and reviewed...
July 19, 2016: American Journal of Clinical Oncology
Vitor Augusto de Andrade, Claudio Saddy Rodrigues Coy, Raquel Franco Leal, João José Fagundes, Carlos Augusto Real Martinez, Maria de Lourdes Setsuko Ayrizono
BACKGROUND: The approach of locally advanced extra-peritoneal rectal adenocarcinoma implies a treatment with neoadjuvant chemoradiotherapy associated with total mesorectal excision surgery. However, the tumors respond variably to this neoadjuvant therapy, and the mechanisms for response are not completely understood. OBJECTIVE: Evaluate the variables related to the complete tumor response and the outcomes of patients who underwent surgery, comparing those with partial tumor regression and those with total remission of rectal lesion, at the pathological examination...
July 2016: Arquivos de Gastroenterologia
Siamak Mohammadkhani Shali, Vanessa Schmitt, Florian F Behrendt, Oliver H Winz, Alexander Heinzel, Felix M Mottaghy, Michael J Eble, Frederik A Verburg
AIM: to determine whether [(18)F]2-fluoro-2-deoxyglucose (FDG) positron emission tomography and X-ray computed tomography (PET/CT) findings and metabolic parameters before combined chemo- and radiotherapy (CRT) have a prognostic value in patients with anal carcinoma. MATERIALS AND METHODS: 45 patients with anal cancer who underwent pre-treatment FDG-PET/CT were included. Metabolic parameters, recurrence and anal carcinoma specific survival were analyzed. RESULTS: SUV max and metabolic volume of the primary tumour were significantly higher in patients with lymph node or distant metastases than in those with locally confined disease (p=0...
August 2016: European Journal of Radiology
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