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Images in HIV/AIDS. The changing face of anal cancer.
AIDS Read. 2008 Apr;18(4):185-7
Authors: Romassi M, Nagle D
PMID: 18472440 [PubMed - in process]
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Images in HIV/AIDS. The changing face of anal cancer.
Fetched: May 14th, 2008, 9:00pm EDT
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EXTRA-A Multicenter Phase II Study of Chemoradiation Using a 5 Day per Week Oral Regimen of Capecitabine and Intravenous Mitomycin C in Anal Cancer.
Fetched: May 13th, 2008, 9:00pm EDT
Related Articles EXTRA-A Multicenter Phase II Study of Chemoradiation Using a 5 Day per Week Oral Regimen of Capecitabine and Intravenous Mitomycin C in Anal Cancer.
Int J Radiat Oncol Biol Phys. 2008 May 7;
Authors: Glynne-Jones R, Meadows H, Wan S, Gollins S, Leslie M, Levine E, McDonald AC, Myint S, Samuel L, Sebag-Montefiore D,
PURPOSE: 5-Fluorouracil (5-FU) + mitomycin C (MMC)-based chemoradiotherapy is standard treatment for patients with epidermoid anal carcinoma. Clinical trials in other cancers have confirmed 5-FU can successfully be replaced by the oral fluoropyrimidine capecitabine. This phase II trial aimed to determine the feasibility, toxicity, and efficacy of capecitabine, MMC and radiotherapy (RT) in anal cancer patients. METHODS AND MATERIALS: Radiotherapy comprised the schedule of the UK Anal Cancer Trial (ACT) II trial (50.4 Gy in 28 fractions of 1.8 Gy). With MMC (12 mg/m(2)) on Day 1 and capecitabine on each RT treatment day in two divided doses (825 mg/m(2) b.i.d). The endpoints were complete response at 4 weeks, local control at 6 months and toxicity. RESULTS: Thirty-one patients entered the trial. The median age was 61 years (range 45-86) with 14 males and 17 females. Compliance with chemotherapy with no dose interruptions or delays was 68%, and with RT was 81%. Eighteen (58%) patients completed both modalities of treatment as planned. Dose-limiting Grade 3 or 4 diarrhea was seen in 1 of 31 patients. Three patients experienced Grade 3 neutropenia. There were no treatment-related deaths. Four weeks following completion of chemoradiation, 24 patients (77%) had a complete clinical response, and 4 (16%) a partial response. With a median follow-up of 14 months, three locoregional relapses occurred. CONCLUSIONS: Capecitabine with MMC and RT in with patients anal carcinoma is well tolerated, with minimal toxicity and acceptable compliance. We recommend testing this schedule in future national Phase III studies in anal cancer.
PMID: 18472366 [PubMed - as supplied by publisher]
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Evaluation of Planned Treatment Breaks during Radiation Therapy for Anal Cancer: Update of RTOG 92-08.
Fetched: May 13th, 2008, 9:00pm EDT
Related Articles Evaluation of Planned Treatment Breaks during Radiation Therapy for Anal Cancer: Update of RTOG 92-08.
Int J Radiat Oncol Biol Phys. 2008 May 7;
Authors: Konski A, Garcia M, John M, Krieg R, Pinover W, Myerson R, Willett C
PURPOSE: Radiation Therapy Oncology Group (RTOG) 92-08 began as a single arm, Phase II trial for patients with anal cancer consisting of radiation (RT) + 5-flourouracil + mitomycin-C with a mandatory 2-week break and was amended after completion to evaluate the same treatment regimen without a treatment break. Long-term efficacy and late toxicity reporting are the specific aims of this study. METHODS AND MATERIALS: Survivals were estimated with the Kaplan-Meier method. Overall survival (OS) was compared with RTOG 87-04 with the log-rank test. Time to local failure, regional failure, locoregional failure (LRF), distant metastases, second primary, and colostomy failure were estimated by the cumulative incidence method. LRF was compared with RTOG 87-04 using the Gray's test. RESULTS: Forty-seven patients entered in the mandatory treatment break cohort. The study was reopened in 1995 to the no mandatory treatment break cohort completing accrual with 20 patients in 1996. Of 67 total patients, 1 patient in the mandatory treatment break portion of the study did not receive any protocol treatment and is excluded from analyses. After adjusting for tumor size, neither cohort showed a statistically significant difference in OS or LRF compared with the RTOG 87-04 mitomycin-C arm. No patient in either cohort experienced a Grade 3 or higher late toxicity. CONCLUSIONS: No statistically significant differences were seen in OS or LRF when compared to the mitomycin-C arm of RTOG 87-04, but the sample sizes for the mandatory break cohort and the no mandatory break cohort are small. Late toxicity was low and similar for the treatment cohorts.
PMID: 18472363 [PubMed - as supplied by publisher]
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Emerging role of intensity-modulated radiation therapy in anorectal cancer.
Fetched: May 10th, 2008, 9:00pm EDT
Related Articles Emerging role of intensity-modulated radiation therapy in anorectal cancer.
Expert Rev Anticancer Ther. 2008 Apr;8(4):585-93
Authors: Meyer JJ, Willett CG, Czito BG
Although radiation therapy has an established role to play in the management of rectal and anal tumors, there are often treatment-related morbidities that negatively impact on patients. There is a long-standing interest in radiation oncology on maximizing treatment efficacy while minimizing treatment-related toxicities, which can be pronounced in the treatment of pelvic malignancies. Intensity-modulated radiation therapy is a recently introduced technology that has the potential to increase the efficacy:toxicity ratio. It has been implemented in the treatment of prostate and head and neck tumors with success. This article reviews the rationale for its use in treating anorectal tumors and discusses early clinical data supporting its continued investigation.
PMID: 18402525 [PubMed - indexed for MEDLINE]
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CHEMORADIOTHERAPY - AN ALTERNATIVE TO SURGERY FOR SQUAMOUS CELL CARCINOMA OF THE RECTUM Report of six cases and literature review.
Fetched: May 9th, 2008, 9:00pm EDT
Related Articles CHEMORADIOTHERAPY - AN ALTERNATIVE TO SURGERY FOR SQUAMOUS CELL CARCINOMA OF THE RECTUM Report of six cases and literature review.
Colorectal Dis. 2008 May 3;
Authors: Rasheed S, Yap T, Zia A, McDonald PJ, Glynne-Jones R
Purpose: Since 1943 (1) only 45 cases of squamous cancer of the rectum have been reported in the English literature, and the largest series consists of 12 cases. Reports suggest the primary treatment is surgical resection but, in the light of non-surgical advances in the treatment of anal squamous cell carcinoma (SCC), we present a review of the literature and report six patients treated by chemoradiation (CRT). Method: A literature search was undertaken using the keywords squamous cell, epidermoid, basaloid and cloacagenic and cancer of rectum and colon to provide evidence for this discussion from studies of surgery, radiation therapy and chemoradiation therapy in rectal SCC. A prospective database of the Mount Vernon Cancer Centre, UK was searched from 1995 to 2005 for patients diagnosed with pure squamous cell carcinoma of the rectum. Results: Six patients with histologically confirmed primary SCC of the rectum were treated with primary combination chemoradiotherapy according to protocols used for squamous cell carcinoma of the anal canal over a 15 year period. Surgery was avoided in four, and they remain disease free on follow up. Conclusions: Primary chemoradiation, as currently utilised in anal cancer, can be extended to primary squamous cell carcinoma of the rectum.
PMID: 18462236 [PubMed - as supplied by publisher]
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Adjuvant electrochemotherapy for incompletely excised anal sac carcinoma in a dog.
Fetched: May 7th, 2008, 9:00pm EDT
Related Articles Adjuvant electrochemotherapy for incompletely excised anal sac carcinoma in a dog.
In Vivo. 2008 Jan-Feb;22(1):47-9
Authors: Spugnini EP, Dotsinsky I, Mudrov N, Bufalini M, Giannini G, Citro G, Feroce F, Baldi A
Canine anal sac gland carcinoma (ASGC) is a frequently described neoplasm that is highly aggressive and can frequently lead to metastatic spread. In this paper, we describe the successful treatment of an incompletely excised ASGC by using cisplatin selectively driven within the tumor cells by trains of biphasic pulses. The dog received two courses of electrochemotherapy 14 days apart. Neither systemic nor local toxicities were detected during the whole course of therapy. The dog is still in complete remission after 18 months. Electrochemotherapy is a safe and efficacious adjuvant therapy for ASGC and warrants further investigation in order to standardize its protocols.
PMID: 18396781 [PubMed - indexed for MEDLINE]
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Intralesional interferon alfa-2b as neoadjuvant treatment for perianal extramammary Paget's disease.
Fetched: May 7th, 2008, 9:00pm EDT
Related Articles Intralesional interferon alfa-2b as neoadjuvant treatment for perianal extramammary Paget's disease.
J Eur Acad Dermatol Venereol. 2008 Apr;22(4):522-3
Authors: Panasiti V, Bottoni U, Devirgiliis V, Mancini M, Rossi M, Curzio M, Calvieri S
PMID: 18363931 [PubMed - indexed for MEDLINE]
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Assessing the impact of FDG-PET in the management of anal cancer.
Fetched: May 3rd, 2008, 9:00pm EDT
Related Articles Assessing the impact of FDG-PET in the management of anal cancer.
Radiother Oncol. 2008 Apr 29;
Authors: Nguyen BT, Joon DL, Khoo V, Quong G, Chao M, Wada M, Joon ML, See A, Feigen M, Rykers K, Kai C, Zupan E, Scott A
PURPOSE: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. METHODS AND MATERIALS: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. RESULTS: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. CONCLUSIONS: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies.
PMID: 18453023 [PubMed - as supplied by publisher]
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Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial.
Fetched: May 1st, 2008, 9:00pm EDT
Related Articles Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial.
JAMA. 2008 Apr 23;299(16):1914-21
Authors: Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB, Thomas CR, Mayer RJ, Haddock MG, Rich TA, Willett C
CONTEXT: Chemoradiation as definitive therapy is the preferred primary therapy for patients with anal canal carcinoma; however, the 5-year disease-free survival rate from concurrent fluorouracil/mitomycin and radiation is only approximately 65%. OBJECTIVE: To compare the efficacy of cisplatin-based (experimental) therapy vs mitomycin-based (standard) therapy in treatment of anal canal carcinoma. DESIGN, SETTING, AND PARTICIPANTS: US Gastrointestinal Intergroup trial RTOG 98-11, a multicenter, phase 3, randomized controlled trial comparing treatment with fluorouracil plus mitomycin and radiotherapy vs treatment with fluorouracil plus cisplatin and radiotherapy in 682 patients with anal canal carcinoma enrolled between October 31, 1998, and June 27, 2005. Stratifications included sex, clinical nodal status, and tumor diameter. INTERVENTION: Participants were randomly assigned to 1 of 2 intervention groups: (1) the mitomycin-based group (n = 341), who received fluorouracil (1000 mg/m2 on days 1-4 and 29-32) plus mitomycin (10 mg/m2 on days 1 and 29) and radiotherapy (45-59 Gy) or (2) the cisplatin-based group (n = 341), who received fluorouracil (1000 mg/m2 on days 1-4, 29-32, 57-60, and 85-88) plus cisplatin (75 mg/m2 on days 1, 29, 57, and 85) and radiotherapy (45-59 Gy; start day = day 57). MAIN OUTCOME MEASURES: The primary end point was 5-year disease-free survival; secondary end points were overall survival and time to relapse. RESULTS: A total of 644 patients were assessable. The median follow-up for all patients was 2.51 years. Median age was 55 years, 69% were women, 27% had a tumor diameter greater than 5 cm, and 26% had clinically positive nodes. The 5-year disease-free survival rate was 60% (95% confidence interval [CI], 53%-67%) in the mitomycin-based group and 54% (95% CI, 46%-60%) in the cisplatin-based group (P = .17). The 5-year overall survival rate was 75% (95% CI, 67%-81%) in the mitomycin-based group and 70% (95% CI, 63%-76%) in the cisplatin-based group (P = .10). The 5-year local-regional recurrence and distant metastasis rates were 25% (95% CI, 20%-30%) and 15% (95% CI, 10%-20%), respectively, for mitomycin-based treatment and 33% (95% CI, 27%-40%) and 19% (95% CI, 14%-24%), respectively, for cisplatin-based treatment. The cumulative rate of colostomy was significantly better for mitomycin-based than cisplatin-based treatment (10% vs 19%; P = .02). Severe hematologic toxicity was worse with mitomycin-based treatment (P < .001). CONCLUSIONS: In this population of patients with anal canal carcinoma, cisplatin-based therapy failed to improve disease-free-survival compared with mitomycin-based therapy, but cisplatin-based therapy resulted in a significantly worse colostomy rate. These findings do not support the use of cisplatin in place of mitomycin in combination with fluorouracil and radiotherapy in the treatment of anal canal carcinoma. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00003596.
PMID: 18430910 [PubMed - indexed for MEDLINE]
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JAMA patient page. Anal cancer.
Fetched: April 24th, 2008, 9:00pm EDT
Related Articles JAMA patient page. Anal cancer.
JAMA. 2008 Apr 23;299(16):1980
Authors: Zeller JL, Lynm C, Glass RM
PMID: 18430917 [PubMed - indexed for MEDLINE]
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Giant anal condylomatosis after allogeneic bone marrow transplantation: a rare complication of human papilloma virus infection.
Fetched: April 23rd, 2008, 9:00pm EDT
Related Articles Giant anal condylomatosis after allogeneic bone marrow transplantation: a rare complication of human papilloma virus infection.
Transpl Infect Dis. 2008 Feb;10(1):56-8
Authors: Ganguly N, Waller S, Stasik CJ, Skikne BS, Ganguly S
Condyloma acuminata or genital warts are caused by human papilloma virus (HPV). Ongoing proliferation of HPV in patients with congenital or acquired immunodeficiency states leads to the development of rapidly progressive and sometimes locally invasive tumor with or without dysplasia. Aggressive treatment, diagnostic immuno-typing, and follow-up are necessary in patients with ongoing immunosuppression. We report a case of giant ano-genital condylomatosis due to HPV types 6 and 11 in a patient with chronic myeloid leukemia after allogeneic bone marrow transplantation. The tumor was successfully treated with surgical excision and local application of 5% imiquimod cream.
PMID: 17511821 [PubMed - indexed for MEDLINE]
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Acquisition of anal human papillomavirus (HPV) infection in women: the Hawaii HPV Cohort study.
Fetched: April 23rd, 2008, 9:00pm EDT
Related Articles Acquisition of anal human papillomavirus (HPV) infection in women: the Hawaii HPV Cohort study.
J Infect Dis. 2008 Apr 1;197(7):957-66
Authors: Goodman MT, Shvetsov YB, McDuffie K, Wilkens LR, Zhu X, Ning L, Killeen J, Kamemoto L, Hernandez BY
BACKGROUND: The majority of anal cancer is associated with human papillomavirus (HPV) infection, yet little is known about women's risk of acquisition of anal HPV infection. METHODS: Risk factors for the acquisition of anal HPV infection were examined in a longitudinal cohort study of 431 women, via repeated measurement of HPV DNA. RESULTS: Seventy percent of women were positive for anal HPV infection at one or more clinic visits from baseline through a follow-up period that averaged 1.3 years. The incidence of a high-risk (HR) infection was 19.5 (95% confidence interval [CI], 16.0-23.6) per 1000 woman-months. The most common incident HR HPV types were HPV-53, -52 and -16. The presence of an HR anal HPV infection at baseline increased the risk of an incident anal infection by 65%. Baseline HR cervical HPV infection also predicted the acquisition of an HR anal HPV infection (odds ratio, 1.81 [95% CI, 1.09-3.02]). Nonviral risk factors for acquisition of HR HPV infection included younger age, lower socioeconomic status, greater lifetime number of sexual partners, past use of hormones, and condom use. CONCLUSIONS: The results of this study suggest that women's risk of anal HPV infection is as common as their risk of cervical HPV infection.
PMID: 18429348 [PubMed - in process]
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Prevalence of and Risk Factors for Anal Human Papillomavirus Infection in Heterosexual Men.
Fetched: April 23rd, 2008, 9:00pm EDT
Related Articles Prevalence of and Risk Factors for Anal Human Papillomavirus Infection in Heterosexual Men.
J Infect Dis. 2008 Apr 21;
Authors: Nyitray A, Nielson CM, Harris RB, Flores R, Abrahamsen M, Dunne EF, Giuliano AR
In US men, the incidence of anal cancer, the primary cause of which is human papillomavirus (HPV) infection, has increased almost 3-fold in 3 decades; however, little is known about the epidemiology of anal HPV infection, especially in heterosexual men. In 2 US cities, behavioral data and anal biological specimens were collected from 253 men who acknowledged having engaged in sexual intercourse with a woman during the preceding year. On the basis of DNA analysis, overall prevalence of anal HPV infection was found to be 24.8% in 222 men who acknowledged having had no prior sexual intercourse with men. Of the men with anal HPV infection, 33.3% had an oncogenic HPV type. Risk factors independently associated with anal HPV were lifetime number of female sex partners and frequency of sex with females during the preceding month. These results suggest that anal HPV infection may be common in heterosexual men.
PMID: 18426367 [PubMed - as supplied by publisher]
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Outcomes of immediate vertical rectus abdominis myocutaneous flap reconstruction for irradiated abdominoperineal resection defects.
Fetched: April 23rd, 2008, 9:00pm EDT
Related Articles Outcomes of immediate vertical rectus abdominis myocutaneous flap reconstruction for irradiated abdominoperineal resection defects.
J Am Coll Surg. 2008 Apr;206(4):694-703
Authors: Butler CE, Gündeslioglu AO, Rodriguez-Bigas MA
BACKGROUND: Perineal wound complications after chemoradiotherapy and abdominoperineal resection (APR) for anorectal cancer occur in up to 60% of patients, including perineal abscess and wound dehiscence. Vertical rectus abdominis myocutaneous (VRAM) flaps have been used in an attempt to reduce these complications by obliterating the noncollapsible dead space with vascularized tissue and closing the perineal skin defect with nonirradiated flap skin. Many surgeons are reluctant to use VRAM flaps unless primary closure is not possible. STUDY DESIGN: All patients who underwent chemoradiotherapy and APR during a 12-year period at the University of Texas MD Anderson Cancer Center were retrospectively reviewed. Patient, tumor, and treatment characteristics and surgical complications and outcomes were compared between patients who underwent VRAM flap reconstruction of wounds that could have been closed primarily (flap group, n = 35) and those who had primary closure of the perineal wound (control group, n = 76). RESULTS: Overall, there were no significant differences in the incidence of perineal wound complications between the groups; the flap group had a significantly lower incidence of perineal abscess (9% versus 37%, p = 0.002), major perineal wound dehiscence (9% versus 30%, p = 0.014), and drainage procedures required for perineal/pelvic fluid collections (3% versus 25%, p = 0.003) than the control group had. Despite flap harvest and the need for donor site closure in the flap group, there was no significant difference in abdominal wall complications between groups during the study's mean patient followup of 3.8 years. CONCLUSIONS: VRAM flap reconstruction of irradiated APR defects reduces major perineal wound complications without increasing early abdominal wall complications. Strong consideration should be given to immediate VRAM flap reconstruction after chemoradiation and APR.
PMID: 18387476 [PubMed - indexed for MEDLINE]
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[Concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal-report of four cases]
Fetched: April 22nd, 2008, 9:00pm EDT
Related Articles [Concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal-report of four cases]
Gan To Kagaku Ryoho. 2008 Mar;35(3):519-22
Authors: Kinjo A, Ogawa K, Iraha S, Tamaki W, Toita T, Kakinohana Y, Samura H, Kinjo I, Nishimaki T, Kuniyoshi Y, Murayama S
We have treated four Japanese patients with squamous cell carcinoma of the anal canal using concurrent chemoradiotherapy. The chemotherapy consisted of one or two cycles of mitomycin C 10 mg/m(2)/day (intravenous bolus injection) on day 1, and 5-fluorouracil 700 or 1,000 mg/m(2)/day (continuous intravenous infusion) on days 2-5 during radiotherapy. The total radiation dose was 40-54 Gy to the primary lesion. Acute grade 4 hematological toxicity was observed in one patient. These four patients have been alive and free of disease (follow-ups of 55, 14, 7 and 5 months, respectively), with excellent function of the anal sphincter after treatment. These results suggest that concurrent chemoradiotherapy is safe and effective for Japanese patients with squamous cell carcinoma of the anal canal.
PMID: 18347409 [PubMed - indexed for MEDLINE]
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Anal human papillomavirus testing with Digene's hybrid capture 2 using two different sampling methods.
Fetched: April 11th, 2008, 9:00pm EDT
Related Articles Anal human papillomavirus testing with Digene's hybrid capture 2 using two different sampling methods.
Dis Colon Rectum. 2008 Jan;51(1):62-6
Authors: Roka F, Roka J, Trost A, Schalk H, Zagler C, Kirnbauer R, Salat A
PURPOSE: The incidence of human papillomavirus detection in the anal canal is rising. Efficient anal screening by cytology is hampered because of poor specificity. Human papillomavirus (HPV) testing is proposed in addition to Papanicolaou (Pap) testing for the detection of cervical neoplasia. The purpose of this study was to determine the usefulness of a human papillomavirus-DNA detection test to detect human papillomavirus-associated disease and to compare two different methods of sample collection. METHODS: In 555 patients, anal samples were obtained by using a cervical brush and a Dacron swab to test for high-risk and low-risk human papillomavirus-DNA. Patients positive for human papillomavirus-DNA underwent anoscopy. Biopsies were taken from visible lesions. RESULTS: Low-risk human papillomavirus-DNA was found in 325 of 555 patients (58.6 percent) and high-risk human papillomavirus-DNA in 285 of 555 patients (51.4 percent). Positive results confined to one single test method were higher for Dacron swab sampling (2.3 vs. 4.3 percent for low-risk human papillomavirus, P < 0.0001; 3.1 vs. 4.9 percent for high-risk human papillomavirus, P < 0.001). A positive correlation of relative light units was found for both sampling methods in the total cohort (P < 0.0001) as well as for patients who tested human papillomavirus-positive by both sampling techniques (P < 0.0001). Sampling with Dacron swabs yielded higher relative light units values compared with sampling with cervical brush for low-risk human papillomavirus-DNA and high-risk human papillomavirus-DNA. CONCLUSIONS: Anal screening for human papillomavirus-DNA by hybrid capture 2 is a useful method for detection of human papillomavirus-associated disease. Sample collection using Dacron swabs identifies more human papillomavirus-positive patients, and yields higher relative light unit values than using the cervical brush. Further studies are needed to determine the exact value of hybrid capture 2 in the screening for (pre)cancerous lesions of the anal canal.
PMID: 18030530 [PubMed - indexed for MEDLINE]
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Practice parameters for anal squamous neoplasms.
Fetched: April 11th, 2008, 9:00pm EDT
Related Articles Practice parameters for anal squamous neoplasms.
Dis Colon Rectum. 2008 Jan;51(1):2-9
Authors: Fleshner PR, Chalasani S, Chang GJ, Levien DH, Hyman NH, Buie WD,
PMID: 18030528 [PubMed - indexed for MEDLINE]
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[The ostomy support team. A reality for ostomates]
Fetched: April 9th, 2008, 9:00pm EDT
Related Articles [The ostomy support team. A reality for ostomates]
Rev Med Chir Soc Med Nat Iasi. 2007 Oct-Dec;111(4):925-31
Authors: Scripcariu V, Dajbog E, Radu I, Mavropol P, Pricop A, Dragomir C
Stoma is a Greek word meaning mouth or opening. There are many types of surgical stomas and they may be raised on many areas of the abdominal wall. A stoma may be temporary or permanent, may be needed in any age group and may be sited on any part of the abdomen. The specific digestive pathology that could have as result of the surgical management a stoma is represented by colon, rectal and anal cancer, diverticular disease of the colon and rectum, Chron's disease, ischaemic bowel, volvulus, trauma, Hirschprung disease, imperforate anus, feacal incontinence. This paper aim is to asses the management of fecal stomas and the necessity of a trained ostomy support team.
PMID: 18389782 [PubMed - in process]
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[Condylomata acuminata and other HPV associated disease pictures of the genitals, anus and urethra]
Fetched: April 9th, 2008, 9:00pm EDT
Related Articles [Condylomata acuminata and other HPV associated disease pictures of the genitals, anus and urethra]
J Dtsch Dermatol Ges. 2008 Feb;6(2):153-62
Authors: Gross G, Ikenberg H, Petry KU, Pfister H, Schneede P, Schöfer H, Szeimies RM
PMID: 18261086 [PubMed - indexed for MEDLINE]
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Patterns of failure and outcome in patients with carcinoma of the anal margin.
Fetched: April 5th, 2008, 9:00pm EDT
Related Articles Patterns of failure and outcome in patients with carcinoma of the anal margin.
Ann Surg Oncol. 2008 Apr;15(4):1092-8
Authors: Khanfir K, Ozsahin M, Bieri S, Cavuto C, Mirimanoff RO, Zouhair A
BACKGROUND: To evaluate the outcome of patients with carcinoma of anal margin in terms of recurrence, survival, and radiation toxicity. METHODS: A series of 45 consecutive patients, with anal margin carcinoma treated between 1983 and 2006 with curative intent at two institutions, was retrospectively analyzed. A surgical excision (close or positive surgical margin in 22 out of 29 patients) was realized before radiotherapy (RT). RT consisted of definitive external beam RT (EBRT) in 36 patients, brachytherapy (BT) alone in two patients, and both BT and EBRT in seven patients. The median total radiation dose was 59.4 Gy (range, 30-74 Gy). RESULTS: The 5-year locoregional control (LRC) rate was 78% [95% confidence interval (CI), 64-93%]. The 5-year disease-specific survival (DSS) and overall survival (OS) rates were respectively 86% (95% CI, 72-99%) and 55% (95% CI, 44-66%). The overall anal conservation rate was 80% for the whole series. There was no significant association between local recurrence and patient age, histological grade, tumor size, T stage, overall treatment time, RT dose, or chemotherapy. Long-term side effects were observed in 15 patients (33%). Only three patients developed grade 3-4 late toxicity (CTCAE/NCI v3.0). Significant relationship was found between dose, and complication rate (48% for dose >or=59.4 Gy versus 8% for dose < 59.4 Gy; P = 0.03). CONCLUSIONS: We conclude that definitive RT and/or BT yield a good local control and disease-specific survival comparable with published data. This study suggests that radiation dose over 59.4 Gy seems to increase treatment-related morbidity.
PMID: 18231838 [PubMed - indexed for MEDLINE]
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Penile Intraepithelial Neoplasia Is Frequent in HIV-Positive Men with Anal Dysplasia.
Fetched: April 4th, 2008, 9:00pm EDT
Related Articles Penile Intraepithelial Neoplasia Is Frequent in HIV-Positive Men with Anal Dysplasia.
J Invest Dermatol. 2008 Apr 3;
Authors: Kreuter A, Brockmeyer NH, Weissenborn SJ, Gambichler T, Stücker M, Altmeyer P, Pfister H, Wieland U
Anogenital human papillomavirus (HPV)-infection is common in HIV-infected men who have sex with men (HIV+MSM). These patients have a strongly increased risk of HPV-induced anal cancer and its precursor lesion, anal intraepithelial neoplasia (AIN), and a moderately increased risk for penile cancer. Only limited data exist on penile intraepithelial neoplasia (PIN) in HIV+MSM. We determined the prevalence and evaluated the virologic characteristics of PIN and AIN in 263 HIV+MSM. In case of histologically confirmed PIN (and AIN), HPV-typing, HPV-DNA load determination, and immunohistochemical staining for p16(INK4a) were performed. PIN was detected in 11 (4.2%) and AIN in 156 (59.3%) patients. Ten PIN patients also had AIN within the observation period. Four clinical types of PINs could be distinguished. High-risk-alpha-HPV-DNA was found in 10 PIN lesions, with HPV16 being the most frequent type. Infections with multiple HPV-types were common. All high-grade lesions had high-risk-HPV-DNA-loads >/=1 HPV-copy/beta-globin-gene-copy. Cutaneous beta-HPVs were found in PIN and AIN, but beta-HPV-DNA loads were very low, irrespective of the histological grade. p16(INK4a) Expression was detectable in all PIN lesions and correlated both with the histological grade and with high-risk HPV-DNA loads. In view of the PIN prevalence found in our study, all HIV+MSM should be screened for PIN in addition to AIN screening.Journal of Investigative Dermatology advance online publication 3 April 2008; doi:10.1038/jid.2008.72.
PMID: 18385760 [PubMed - as supplied by publisher]
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Squamous-cell carcinoma of the anal canal: predictors of treatment outcome.
Fetched: April 4th, 2008, 9:00pm EDT
Related Articles Squamous-cell carcinoma of the anal canal: predictors of treatment outcome.
Dis Colon Rectum. 2008 Feb;51(2):147-53
Authors: Roohipour R, Patil S, Goodman KA, Minsky BD, Wong WD, Guillem JG, Paty PB, Weiser MR, Neuman HB, Shia J, Schrag D, Temple LK
PURPOSE: The incidence of anal canal squamous-cell carcinoma is increasing. Limited data exist on predictors of treatment failure. This study was designed to identify predictors for relapse/persistence after first-line therapy. METHODS: Using one database, we identified 131 Stages I-III patients treated for primary anal canal squamous-cell carcinoma at our institution from December 1986 to August 2006, with minimum six-month follow-up. Demographic, pathologic, treatment, and outcome data were extracted. Treatment failure was defined as biopsy-proven persistence or relapse (local and/or distant). Univariate, bivariate, and multivariate survival analyses were performed. RESULTS: Of 131 patients (median age, 58.3 years; median follow-up, 2.9 (range, 0.6-11.2) years), 66 percent were females, 43.5 percent were Stage II, and 11 (8 percent) were HIV-positive. Surgery only (local excision) was uncommon (6.9 percent, n=9). One hundred twenty-two patients (93.1 percent) received radiotherapy; two required preradiotherapy diversion. Although 114 (93.4 percent) completed radiotherapy, most required treatment breaks, making total duration of radiotherapy longer than planned. Almost all patients undergoing radiotherapy (96.7 percent, 118/122) also had chemotherapy: 118 (100 percent, Stages I-III) had concurrent chemotherapy: (98 (83.8 percent) mitomycin/5-fluorouracil, 12 (10.2 percent) cisplatin/5-fluorouracil, 8 (6.8 percent) 5-fluorouracil alone); 35 of 46 (76 percent) Stage III patients received induction chemotherapy (34 (97.1 percent) cisplatin/5-fluorouracil, 1 (2.8 percent) 5-fluorouracil alone). Many (44 percent Stages I/II, 48.9 percent Stage III) required dose adjustments. Thirty-seven patients (28.2 percent) failed first-line therapy. There were no differences between patients with relapse (n=22) or persistence (n=15) of disease. Bivariate analyses demonstrated that T stage (P=0.0019), completion of radiotherapy, and total radiotherapy dose (P=0.03) were all significantly associated with treatment failure. On multivariate analyses, disease stage (P=0.05) and completion of radiotherapy (P=0.01) remained significant predictors of relapse-free survival. CONCLUSIONS: Tolerance of chemoradiation seems to be an important predictor of treatment success. Effective therapies with less acute toxicity must be identified.
PMID: 18180997 [PubMed - indexed for MEDLINE]
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FDG uptake in a rectal malignant melanoma.
Fetched: April 4th, 2008, 9:00pm EDT
Related Articles FDG uptake in a rectal malignant melanoma.
Acta Oncol. 2007;46(7):1030-1
Authors: Tai CJ, Hsu CH, Chiou JF, Wu CH, Lin SE
PMID: 17917831 [PubMed - indexed for MEDLINE]
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Perianal fibroadenoma, case report.
Fetched: March 26th, 2008, 9:00pm EDT
Related Articles Perianal fibroadenoma, case report.
Am J Dermatopathol. 2008 Feb;30(1):81-3
Authors: Doganavsargil B, Akalin T, Ylmaz M, Kandiloglu G
Extramammary fibroadenomas, occurring in the anogenital region, are rare lesions thought to be arising from "mammary-like anogenital sweet glands" described by van der Putte. We present a 42-year-old woman with a slow-growing, 4-cm, well-circumscribed but nonencapsulated mass in perianal region. The cut surface of the lesion was bulging, gray-white, and slightly lobulated. Microscopically, it was identical to mammary fibroadenoma and composed of concurrent glandular and stromal elements. Low columnar or cuboidal cells with focal, apical cytoplasmic snouts lined the glands, whereas the underlying layer had myoepithelial cell features, expressing smooth muscle actin and S-100. Epithelial component was immunoreactive for human milk fat globulin I. Progesterone receptor positivity was 80%, whereas the estrogen receptor expression was 60%. Gross cystic disease fluid protein and human milk fat globulin II were negative. The case is presented to increase the awareness on mammary-like glands of anogenital region, which may give rise to not only fibroadenomas but also fibrocystic disease, phyllodes tumor, carcinoma in situ, invasive carcinoma and lactating adenoma, hidrocystoma, hidradenoma papilliferum, intraductal papilloma, and sclerosing adenosis, although very rare.
PMID: 18212553 [PubMed - indexed for MEDLINE]
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Intertriginous plasmacytosis with plasmoacanthoma: report of a typical case and review of the literature.
Fetched: March 21st, 2008, 9:00pm EDT
Related Articles Intertriginous plasmacytosis with plasmoacanthoma: report of a typical case and review of the literature.
Int J Dermatol. 2008 Mar;47(3):265-8
Authors: Senol M, Ozcan A, Aydin NE, Hazneci E, Turan N
Clinical manifestations of benign (reactive) plasma cell proliferations of the skin and mucosa consist of a relatively rare and distinct group in dermatologic disorders. They have generally been named according to their localization. We report a typical case of mucocutaneous plasmacytosis located on intertriginous areas of the skin as well as mucosa with a perianal tumoral mass diagnosed as plasmoacanthoma. To our knowledge, this is the first detailed case report, at least in English literature.
PMID: 18289329 [PubMed - indexed for MEDLINE]
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Median effective local anesthetic doses of plain bupivacaine and ropivacaine for spinal anesthesia administered via a spinal catheter for brachytherapy of the lower abdomen.
Fetched: March 21st, 2008, 9:00pm EDT
Related Articles Median effective local anesthetic doses of plain bupivacaine and ropivacaine for spinal anesthesia administered via a spinal catheter for brachytherapy of the lower abdomen.
Reg Anesth Pain Med. 2008 Jan-Feb;33(1):4-9
Authors: Michalek-Sauberer A, Kozek-Langenecker SA, Heinzl H, Deusch E, Chiari A
BACKGROUND AND OBJECTIVES: Continuous spinal anesthesia via a spinal catheter allows adjusting the duration and extent of anesthesia to surgical needs, maintenance of hemodynamic stability, and good postoperative analgesia. This study was designed to determine the median effective local anesthetic dose of plain ropivacaine and bupivacaine administered intrathecally for interstitial brachytherapy of the lower abdomen using the Dixon up-and-down method. METHODS: Forty patients were randomly allocated to receive either intrathecal bupivacaine 5 mg per mL or ropivacaine 10 mg per mL via a 24-gauge spinal catheter at the L3-4 interspace. The initial dose was 10 mg of bupivacaine or 20 mg of ropivacaine; the dosing intervals were 1 mg and 2 mg, respectively. Doses for subsequent patients were determined by the response of the previous patient in that group. Successful anesthesia was defined as a loss of sensation to a cold stimulus at the T6 level and full motor blockade within 20 minutes after administration of the local anesthetic. RESULTS: The median effective local anesthetic dose for intrathecal bupivacaine was 11.2 mg (95% confidence interval [CI], 10.3-12.1) and 22.6 mg for ropivacaine (95% CI, 20.5-24.6). A relative analgesic potency ratio of 0.50 (95% CI, 0.44-0.56) was calculated between the median effective local anesthetic dose of intrathecal bupivacaine and ropivacaine. CONCLUSIONS: Bupivacaine and ropivacaine are appropriate for continuous spinal anesthesia for interstitial radiation therapy procedures of the lower abdomen. In the dose-ranges investigated, intrathecal ropivacaine is approximately half as potent as bupivacaine.
PMID: 18155050 [PubMed - indexed for MEDLINE]
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Gene expression reveals two distinct groups of anal carcinomas with clinical implications.
Fetched: March 20th, 2008, 9:00pm EDT
Related Articles Gene expression reveals two distinct groups of anal carcinomas with clinical implications.
Br J Cancer. 2008 Mar 18;
Authors: Bruland O, Fluge O, Immervoll H, Balteskard L, Myklebust MP, Skarstein A, Dahl O
Human papillomavirus (HPV) is a major aetiological agent in anal carcinomas. We here present a study of global gene expression using microarray hybridisation in a collection of anal carcinoma biopsies. Quantitative PCR was used to verify expression of selected genes. All biopsies contained integrated DNA of human papillomavirus subtype 16 (HPV16) and expressed HPV16 E7 mRNA. No other subspecies of HPV were detected in these 13 biopsies as assessed by PCR amplification and DNA sequencing. Unsupervised cluster analysis, based on global mRNA expression, divided the tumour biopsies into two distinct groups. Cluster analysis based on a number of high-risk HPV and/or E2F-regulated genes reproduced this biopsy grouping, suggesting that integrated HPV16 substantially influenced global gene expression in approximately half the biopsies studied. The levels of HPV16 E7 mRNA were significantly different between the two groups, but with considerable overlap. Thus, influence on global gene expression could not be absolutely ascribed to the expression level of HPV16. To investigate whether this distinction in gene expression had prognostic impact, we studied protein expression in an independent cohort of 55 anal carcinomas not included in the microarray study of two differentially expressed candidate genes, minichromosome maintenance complex component 7 (MCM7) and cyclin-dependent kinase inhibitor 2A (CDKN2A or p16). HPV status was assessed by in situ hybridisation. There was a significant association between in situ staining for HPV E7 mRNA and immunostaining for CDKN2A (p16) and MCM7 protein. CDKN2A (p16) mRNA was found significantly differentially expressed between the two tumour groups. However, cluster analysis on genes directly regulated by CDKN2A (p16) could not reproduce this split of biopsies into two groups, suggesting that the transcriptional regulatory activity of CDKN2A in these biopsies is inhibited. Furthermore, protein expression of CDKN2A (p16) could not be associated with survival. MCM7 is directly regulated by E2F and induced by HPV, and its mRNA was found differentially expressed between the two tumour groups. High level of MCM7 protein was found to be associated with both improved relapse-free survival (RFS, P=0.02) and cancer-specific survival (CSS, P=0.03) in anal cancer patients treated with radiation with or without additional chemotherapy.British Journal of Cancer advance online publication, 18 March 2008; doi:10.1038/sj.bjc.6604285 www.bjcancer.com.
PMID: 18349847 [PubMed - as supplied by publisher]
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Analysis of centrosome overduplication in correlation to cell division errors in high-risk human papillomavirus (HPV)-associated anal neoplasms.
Fetched: March 20th, 2008, 9:00pm EDT
Related Articles Analysis of centrosome overduplication in correlation to cell division errors in high-risk human papillomavirus (HPV)-associated anal neoplasms.
Virology. 2008 Mar 1;372(1):157-64
Authors: Duensing A, Chin A, Wang L, Kuan SF, Duensing S
High-risk HPV-associated anal neoplasms are difficult to treat and biomarkers of malignant progression are needed. A hallmark of carcinogenic progression is genomic instability, which is frequently associated with cell division errors and aneuploidy. The HPV-16 E7 oncoprotein has been previously shown to rapidly induce centriole and centrosome overduplication and to cooperate with HPV-16 E6 in the induction of abnormal multipolar mitoses. Based on this function, it has been suggested that HPV-16 E7 may act as a driving force for chromosomal instability. However, a detailed analysis of centrosome overduplication in primary HPV-associated neoplasms has not been performed so far. Here, we determined the frequency of centrosome overduplication in HPV-associated anal lesions using a recently identified marker for mature maternal centrioles, Cep170. We detected centrosome overduplication in a small but significant fraction of cells. Remarkably, centrosome overduplication, but not aberrant centrosome numbers per se or centrosome accumulation, correlated significantly with the presence of cell division errors. In addition, our experiments revealed that in particular pseudo-bipolar mitoses may play a role in the propagation of chromosomal instability in high-risk HPV-associated tumors. These results provide new insights into the role of centrosome aberrations in cell division errors and encourage further studies on centrosome overduplication as a predictive biomarker of malignant progression in HPV-associated anal lesions.
PMID: 18036631 [PubMed - indexed for MEDLINE]
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The evolution of HPV-related anogenital cancers reported in Quebec - Incidence rates and survival probabilities.
Fetched: March 18th, 2008, 9:00pm EDT
Related Articles The evolution of HPV-related anogenital cancers reported in Quebec - Incidence rates and survival probabilities.
Chronic Dis Can. 2008;28(3):99-106
Authors: Louchini R, Goggin P, Steben M
Non-cervical anogenital cancers (i.e. anal, vulvar, vaginal and penile cancers) associated with the human papillomavirus (HPV), for which HPV is known to be the necessary cause of carcinogenesis, are poorly documented due to their relatively low incidence rate. The aim of this study is to describe the incidence rates of these cancers between 1984 and 2001, and their relative survival probabilities, in Quebec (Canada) between 1984 and 1998. The incidence of these cancers is on the rise, particularly anal cancer in women and, more recently (since 1993-95), vulvar cancer. Between 1984-86 and 1993-95, the 5-year relative survival probability for men with anal cancer decreased from 57% to 46%, while that for penile cancer dropped from 75% to 59%. However, during the same period, the 5-year relative survival probability for women with anal cancer rose from 56% to 65%, and remained stable for cervical and vulvar cancers, at 74% and 82%, respectively.
PMID: 18341764 [PubMed - in process]
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Leiomyosarcoma of the anal canal: case report and review of the literature.
Fetched: March 18th, 2008, 9:00pm EDT
Related Articles Leiomyosarcoma of the anal canal: case report and review of the literature.
Am Surg. 2008 Jan;74(1):76-8
Authors: Thalheimer L, Richmond B, Lohan J
A rare case of a leiomyosarcoma of the anal canal is presented. A 68-year-old male presented with painful defecation and rectal bleeding. Endorectal ultrasound revealed a mass invading both sphincters (T4 lesion), and extending 6 cm into the anal canal. Colonoscopy revealed an ulcerated area in the anal canal, of which biopsies revealed high-grade leiomyosarcoma--only the eighteenth such case at the time of this submission. The details of the case and teaching images are presented in detail, as is a comprehensive review of the relevant literature.
PMID: 18274436 [PubMed - indexed for MEDLINE]
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Adenocarcinoma arising from chronic perianal Crohn's disease: case report and review of the literature.
Fetched: March 18th, 2008, 9:00pm EDT
Related Articles Adenocarcinoma arising from chronic perianal Crohn's disease: case report and review of the literature.
Am Surg. 2008 Jan;74(1):59-61
Authors: Smith R, Hicks D, Tomljanovich PI, Lele SB, Rajput A, Dunn KB
Perianal disease is a common manifestation of Crohn's disease. Rarely malignancy arises in perianal fistulas. The etiology of fistula related cancer remains a subject of debate. We present a unique case of a perianal Crohn's disease with adenomatous epithelialization of a fistula tract and an associated mucinous adenocarcinoma. Our case demonstrates that mucinous adenocarcinoma can arise in long standing perianal Crohn's disease and may be associated with adenomatous transformation of the epithelial lining of the fistula tract.
PMID: 18274431 [PubMed - indexed for MEDLINE]
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Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients.
Fetched: March 18th, 2008, 9:00pm EDT
Related Articles Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients.
BMC Cancer. 2008;8:8
Authors: Cho BC, Ahn JB, Seong J, Roh JK, Kim JH, Chung HC, Sohn JH, Kim NK
BACKGROUND: The objectives of this study were to evaluate long-term results of concurrent chemoradiotherapy (CRT) with 5-fluorouracil and cisplatin and the potential benefit of consolidation chemotherapy in patients with anal squamous cell carcinoma (ASCC). METHODS: Between January 1995 and February 2006, 31 patients with ASCC were treated with CRT. Radiotherapy was administered at 45 Gy over 5 weeks, followed by a boost of 9 Gy to complete or partial responders. Chemotherapy consisted of 5-fluorouracil (750 or 1,000 mg/m2) daily on days 1 to 5 and days 29 to 33; and, cisplatin (75 or 100 mg/m2) on day 2 and day 30. Twelve patients had T3-4 disease, whereas 18 patients presented with lymphadenopathy. Twenty-one (67.7%) received consolidation chemotherapy with the same doses of 5-fluorouracil and cisplatin, repeated every 4 weeks for maximum 4 cycles. RESULTS: Nineteen patients (90.5%) completed all four courses of consolidation chemotherapy. After CRT, 28 patients showed complete responses, while 3 showed partial responses. After a median follow-up period of 72 months, the 5-year overall, disease-free, and colostomy-free survival rates were 84.7%, 82.9% and 96.6%, demonstrating that CRT with 5-fluorouracil and cisplatin yields a good outcome in terms of survival and sphincter preservation. No differences in 5-year OS and DFS rates between patients treated with CRT alone and CRT with consolidation chemotherapy was observed. CONCLUSION: our study shows that CRT with 5-FU and cisplatin, with or without consolidation chemotherapy, was well tolerated and proved highly encouraging in terms of long-term survival and the preservation of anal function in ASCC. Further trials with a larger patient population are warranted in order to evaluate the potential role of consolidation chemotherapy.
PMID: 18194582 [PubMed - indexed for MEDLINE]
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Solitary extramedullary plasmacytoma of anorectum.
Fetched: March 15th, 2008, 9:00pm EDT
Related Articles Solitary extramedullary plasmacytoma of anorectum.
Int J Colorectal Dis. 2007 Sep;22(9):1117-8
Authors: Lao W, Chen L, Zhu H, Song Z, Huang X, Wang D, Lin J, He C, Mao W
PMID: 17375312 [PubMed - indexed for MEDLINE]
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The role of viral and bacterial pathogens in gastrointestinal cancer.
Fetched: March 14th, 2008, 9:00pm EDT
The role of viral and bacterial pathogens in gastrointestinal cancer.
J Cell Physiol. 2008 Mar 12;
Authors: Selgrad M, Malfertheiner P, Fini L, Goel A, Boland CR, Ricciardiello L
The association of Helicobacter pylori (H. pylori) with gastric cancer is thus far the best understood model to comprehend the causal relationship between a microbial pathogen and cancer in the human gastrointestinal tract. Besides H. pylori, a variety of other pathogens are now being recognized as potential carcinogens in different settings of human cancer. In this context, viral causes of human cancers are central to the issue since these account for 10-20% of cancers worldwide. In the case of H. pylori and gastric cancer, as well as the human papillomavirus and anal cancer, the causal relationship between the infectious agent and the related cancer in the gastrointestinal tract has been clearly confirmed by epidemiological and experimental studies. Similarly, Epstein-Barr virus and the oncogenic JC virus are being suggested as possible causative agents for cancers in the upper and lower gastrointestinal tract. This review discusses various viral and microbial pathogens and their oncogenic properties in the evolution of gastrointestinal carcinogenesis and summarizes the available experimental data make a convincing agreement favoring the associations between infectious agents and specific human cancers. J. Cell. Physiol. (c) 2008 Wiley-Liss, Inc.
PMID: 18338378 [PubMed - as supplied by publisher]
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Feasibility of the sentinel node biopsy in anal cancer.
Fetched: March 14th, 2008, 9:00pm EDT
Feasibility of the sentinel node biopsy in anal cancer.
Q J Nucl Med Mol Imaging. 2008 Mar 12;
Authors: Mistrangelo M, Bellò M, Mobiglia A, Beltramo G, Cassoni P, Milanesi E, Cornaglia S, Pelosi E, Giunta F, Sandrucci S, Mussa A
AIM: Anal cancer is a rare neoplasm. According to a European Organization for Research and Treatment of Cancer multivariate analysis, synchronous inguinal lymph node metastasis occurs in 10-25% of patients and constitutes an independent prognostic factor for local failure and overall mortality. METHODS: Inguinal lymph node status was assessed using the sentinel node technique in 35 patients with anal cancer. RESULTS: Histology revealed 23 squamous carcinomas, 10 basaloid carcinomas, 1 squamous carcinoma with basaloid areas and 1 spinocellular epithelioma associated with areas of Bowen's disease. Disease stage was T1 in 5 patients, T2 in 18, T3 in 11 and T4 in 1 patient. Lympho-scintigraphy using a GE Millennium gamma camera was performed after peritumoral injection of 37 MBq of (99m)Tc colloid. Surgical sentinel node biopsy with a portable Scintiprobe MR 100 (Politech(R), Carsoli, Italy) had a detection rate of 97.1%. Inguinal metastases were detected in 7 (20%) patients, in 2 of which metastasis was bilateral. CONCLUSION: Given the correlation between prognosis and node involvement, sentinel node biopsy can be considered a simple method for adequate pretreatment staging of anal carcinoma. Use of the technique could avert the need for prophylactic inguinal radiotherapy in N0-N1 patients, thus reducing the morbidity associated with inguinal radiotherapy. Consistent follow-up is required to evaluate long-term results.
PMID: 18337684 [PubMed - as supplied by publisher]