National Cancer Institute®
Last Modified: February 1, 2002
UI - 11776626
AU - Wang L; Yu Z; Qian T
TI - [Radiotherapy for early anal cancer: a report of 27 cases]
SO - Zhonghua Zhong Liu Za Zhi 1999 Nov;21(6):455-7
AD - Cancer Istitute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021.
OBJECTIVE: To evaluate the results of radiotherapy for early stage anal cancer. METHODS: During 1960 through 1993, 27 patients with stage T1-2N0 anal cancer were treated by radiotherapy alone. Seven cases received pelvic irradiation plus local field boost, 20 cases received local field irradiation alone. Kaplan-Meier method was used in survival analysis. RESULTS: The overall 5-year survival rate in this series of patients was 79.1%. Eighteen of the 27 cases had their anal functions preserved. Local recurrence occurred in 7 cases and regional lymph node metastasis in one case. Five of them were salvaged, two by surgery and three by irradiation. CONCLUSION: Radiotherapy alone for early anal cancer is effective. Anal function is preserved in about two-thirds of the patients so treated. Local treatment failure can be salvaged by surgery or radiotherapy.
UI - 11677963
AU - Indinnimeo M; Cicchini C; Stazi A; Limiti MR; Ghini C; Mingazzini PL;
TI - Vecchione A Prognostic impact of CD31 antigen expression in anal canal carcinoma.
SO - Hepatogastroenterology 2001 Sep-Oct;48(41):1355-8
AD - Department of Surgery Pietro Valdoni, Universita di Roma La Sapienza, via del Policlinico, 155, 00161 Rome, Italy. email@example.com
BACKGROUND/AIMS: CD31 is a platelet endothelial cell adhesion molecule. Thus CD31 immunostaining of vascular endothelial cells can be used to measure degree of angiogenesis. As angiogenesis is necessary for tumor growth and metastasis, microvessels density could be a predictor of prognosis. The purpose of this study was to examine the relationship between CD31 value and standard pathologic parameters and prognosis of anal canal carcinoma. METHODOLOGY: Twenty-four patients with anal canal carcinoma were evaluated. Five-micron sections of formalin-fixed, paraffin-embedded tissue were tested with monoclonal anti-CD31 antibody. CD31 value is considered positive if more than 185 vessels/mm2 were counted. Pearson's chi 2 test was employed to test for association between CD31 value and clinicopathological variables. RESULTS: We found no correlation between CD31 value and histologic type, lymph node involvement, patients age and neoplastic relapse. Significant correlation was found between CD31 score and depth of parietal invasion. CONCLUSIONS: The relapse type could strengthen the hypothesis that increased vascularity promotes neoplastic dissemination. As angiogenesis could be used as prognostic indicator to determine patients who may be at higher risk for relapse, our results warrant further confirmation. Development of markers of angiogenic activity in anal canal carcinoma must be an integral part of proper clinical trials.
UI - 11803628
AU - Kouas A; Hachicha I; Dahmane Y; Ben Ali A; Derbel F; Letaief R; Ben Hadj
TI - Hamida R [Anal metastasis of colonic adenocarcinoma?]
SO - Ann Chir 2001 Dec;126(10):1026-8
AD - Service de chirurgie generale et digestive, hopital Sahloul, Sousse, Tunisie.
Two cases of sigmoid and anal adenocarcinoma are reported. The two patients were treated by abdominoperineal resection of the rectum and resection of the sigmoid colon. The relationship between colonic adenocarcinoma and anal adenocarcinoma is not obvious but possible. The various mechanisms of tumoral spread are discussed and the most frequent mechanism seems to be cellular exfoliation.
UI - 11786758
AU - Tarantino D; Bernstein MA
TI - Endoanal ultrasound in the staging and management of squamous-cell carcinoma of the anal canal: potential implications of a new ultrasound staging system.
SO - Dis Colon Rectum 2002 Jan;45(1):16-22
AD - Division of Colon and Rectal Surgery, St. Luke's/Roosevelt Hospital Center, New York, New York, USA.
PURPOSE: This study was performed to determine whether endoanal ultrasound could be used to accurately stage patients with squamous-cell carcinoma of the anal canal and to determine the response of these tumors to multimodality therapy. METHODS: Thirteen consecutive patients with biopsy-proven squamous-cell carcinoma of the anal canal between 1996 and 1999 were included in the study. All patients underwent a pretreatment staging endoanal ultrasound with a B&K 3535 ultrasound machine using the 1850 rotating 360 degrees probe with a 10-MHz transducer. Tumors were staged using our own modification of a 1984 TNM staging system. For our study, a uT1 tumor was confined to the submucosa; a uT2a lesion invaded only the internal anal sphincter; a uT2b lesion penetrated into the external anal sphincter; a uT3 lesion invaded through the sphincter complex into the perianal tissues; and a uT4 lesion invaded adjacent structures. After the initial study, patients decided on a course of treatment, either primary surgery or chemoradiation. For patients choosing chemoradiation, a clinical examination with biopsies and a repeat endoanal ultrasound was performed after completion of therapy. Findings on physical examination and biopsy results were compared with the follow-up endoanal ultrasound. For those choosing surgery, the pathology specimen from the abdominoperineal resection was reviewed and compared with the initial endoanal ultrasound interpretation to determine the accuracy of endoanal ultrasound staging. RESULTS: One patient died of complications from acquired immunodeficiency syndrome before undergoing definitive treatment for his anal cancer. Of the remaining 12 patients who comprised the study, the endoscopic staging was as follows: 1 uT1, 5 uT2a, 3 uT2b, 2 uT3, and 1 uT4. Five of the 12 patients selected surgery as the primary treatment modality for their disease. The other seven patients underwent a full course of chemoradiation. In all five patients who had an abdominoperineal resection, the surgical staging correlated with the endoanal ultrasound staging (2 T2a tumors and 3 T2b tumors). In the remaining seven patients, six to eight weeks after completion of therapy, there was no evidence of residual tumor by clinical examination and biopsies. In one of the seven patients, no abnormalities were detected on endoanal ultrasound, and it was interpreted as normal with no evidence of disease. In the remaining six patients, endoanal ultrasound revealed abnormalities that were judged to represent radiation-induced changes rather than residual disease. A repeat endoanal ultrasound was done in these patients two to four months after the biopsies. Complete resolution of the postradiation changes occurred in all patients, and the scans were interpreted as showing no evidence of disease. CONCLUSIONS: Endoanal ultrasound can accurately determine the depth of penetration of squamous-cell carcinoma into the sphincter complex and can be used to gauge accurately the response of these tumors to chemoradiation therapy. Our newly proposed ultrasound staging system may be more useful in choosing treatment options; future studies should be aimed at using endoanal ultrasound in identifying early lesions that may be amenable to less aggressive therapy as well as determining the utility of ultrasound in the surveillance of patients after successful treatment of their initial tumors.
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