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Larkins MC, Bhatt A, Irish W, Kennedy KN, Burke A, Armel K, Honaker MD. Squamous cell carcinoma of the colon: evaluation of treatment modalities and survival. J Gastrointest Surg 2024:S1091-255X(24)00447-5. [PMID: 38723998 DOI: 10.1016/j.gassur.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/24/2024] [Accepted: 05/04/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Squamous cell carcinoma of the colon (CSCC) is a rare subtype of colon cancer. This study aimed to evaluate treatment strategies and overall survival (OS). METHODS Using the Surveillance, Epidemiology, and End Results program database from 2008 to 2019, patients aged 18 years with CSCC were identified. Treatment strategies and OS were summarized using the Kaplan-Meier analysis and the log-rank test. Adjusted Cox proportional hazards regression model ratios were calculated to evaluate the effect of confounding variables. RESULTS After exclusions, 153 patients met the inclusion criteria. The most common treatment modalities included surgery alone (52.1%), surgery and adjuvant chemotherapy (12.9%), and no treatment (26.4%). Kaplan-Meier analysis revealed that patients who underwent surgery and adjuvant chemotherapy had significant improvements in OS (log-rank P = .002). Cox regression analysis revealed tumor grade (hazard ratio [HR], 2.12; 95% CI, 1.17-3.86) and receipt of chemotherapy (HR, 2.66; 95% CI, 1.23-5.76) as the only factors associated with improvements in OS. CONCLUSION Patients who underwent surgery in combination with chemotherapy had better OS than those who underwent surgery alone. Tumor grade and receipt of chemotherapy were independently associated with OS.
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Affiliation(s)
- Michael C Larkins
- Brody School of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Arjun Bhatt
- Brody School of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - William Irish
- Division of Surgical Research, Department of Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Katie N Kennedy
- Department of Hematology and Oncology, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Aidan Burke
- Department of Radiation Oncology, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Kristen Armel
- Brody School of Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
| | - Michael D Honaker
- Division of Surgical Oncology, Department of Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States.
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2
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Id Said B, Buchan D, Liu Z, Kim J, Hosni A, Brierley JD, Chadi S, Grant RC, Kalimuthu S, Liu ZA, Lukovic J. Demographics, pattern of practice and clinical outcomes in rectal squamous cell carcinoma. Colorectal Dis 2022; 25:608-615. [PMID: 36394982 DOI: 10.1111/codi.16417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022]
Abstract
AIM The aim of this study was to describe the baseline clinical features, treatment patterns and outcomes in rectal squamous cell carcinoma (SCC). METHOD This is a retrospective study of patients with rectal SCC treated at the Princess Margaret Cancer Centre (Toronto, Canada) between 1 January 1995 and 31 December 2020. Clinical factors associated with locoregional failure (LRF), distant metastases (DM), disease-free survival (DFS) and overall survival (OS), such as age, sex, HIV status, T-category, nodal status, grade and primary treatment, were investigated with univariate analysis (UVA). RESULTS Twenty nine patients with rectal SCC were analysed with a median follow-up of 7.4 years (range 0.3-20.4 years). The median age at diagnosis was 52 years, with the majority presenting with clinical T3 disease or higher (n = 21, 72%) and positive regional lymph nodes (n = 16, 55%), while more than quarter of patients (28%) had metastatic disease. Definitive chemoradiation was the treatment modality of choice in more than half of all cases (n = 17, 59%) with a response rate of 100%. The 10-year cumulative incidence of LRF and DM was, respectively, 12% (95% CI 1.8%-32.9%) and 31% (95% CI: 12.0%-52.6%). The 5- and 10-year OS was 82% (95% CI 66.1%-100%). UVA revealed a trend towards an association of male gender (hazard ratio = 4.65, 95% CI 0.9%-24.1; p = 0.067) and primary surgical treatment (hazard ratio = 0.76, 95% CI 0.09-6.34; p = 0.061) with DFS. CONCLUSION Definitive chemoradiation is an effective and preferred treatment for rectal SCC allowing for sphincter preservation with complete clinical response observed in all patients.
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Affiliation(s)
- Badr Id Said
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - David Buchan
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Zijin Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John Kim
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - James D Brierley
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Sami Chadi
- Department of General Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Robert C Grant
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sangeetha Kalimuthu
- Department of Pathology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Zhihui Amy Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jelena Lukovic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
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Linardoutsos D, Frountzas M, Feakins RM, Patel NH, Simanskaite V, Patel H. Primary colonic squamous cell carcinoma: a case report and review of the literature. Ann R Coll Surg Engl 2020; 102:e1-e7. [PMID: 32538102 PMCID: PMC7591611 DOI: 10.1308/rcsann.2020.0149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 02/06/2023] Open
Abstract
Colonic squamous cell carcinoma is extremely rare, with no clear pathogenesis. It usually presents as an emergency. We present the surgical management of a descending colon squamous cell carcinoma, together with a review of the available cases of colonic squamous cell carcinoma in the literature. A 69-year-old woman presented with a palpable mass and abdominal pain. She underwent ultrasound and colonoscopy, which revealed a large obstructing mass at the descending colon, the biopsies of which were not diagnostic. Unfortunately, she was readmitted with bowel obstruction and underwent extended right hemicolectomy with en-bloc excision of attached small bowel and omentum because of local mass expansion. Histopathological analysis demonstrated squamous cell carcinoma with lymph node metastases. Palliative chemotherapy followed, owing to liver and peritoneal deposits. Sixty-six cases of colonic squamous cell carcinoma have been reported in the literature. The most common location is the right colon. Most cases present at a late stage. Several theories for the pathogenesis of colonic squamous cell carcinoma have been reported; the most popular is the squamous transformation of a pluripotent stem cell.
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Affiliation(s)
- D Linardoutsos
- Department of Colorectal Surgery, Barts Health NHS Trust, London UK
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece
| | - M Frountzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece
| | - RM Feakins
- Department of Histopathology, Barts Health NHS Trust, London UK
| | - NH Patel
- Department of Colorectal Surgery, Barts Health NHS Trust, London UK
| | - V Simanskaite
- Department of Histopathology, Barts Health NHS Trust, London UK
| | - H Patel
- Department of Colorectal Surgery, Barts Health NHS Trust, London UK
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Ali Husain AH, Kaundinya KB, Hammed F, Al Sayed AR. The surprise pathology-Primary squamous cell carcinoma of the colon-A case report. Int J Surg Case Rep 2020; 72:75-78. [PMID: 32516701 PMCID: PMC7283961 DOI: 10.1016/j.ijscr.2020.05.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/14/2020] [Accepted: 05/22/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Primary squamous cell carcinomas are rare in the colon. Identified as colonic growths causing obstructive or ulcerative features, they are treated like usual colonic adenocarcinomas until the surprise findings on histopathology. A thorough search for possible primary with colonic metastasis is warranted prior to confirmation of diagnosis. They can coexist with adenocarcinomas and ulcerative colitis. We present this case with intent to add to existing literature the presentation and catastrophic clinical course of the disease in our patient. CLINICAL FINDINGS The patient presented with obstructive pattern of a colonic growth with rapid weight loss. There was no family history of colonic disease and the patient did not suffer from inflammatory bowel disease. DIAGNOSIS AND THERAPEUTIC INTERVENTION CT Scan of the abdomen revealed the growth which was infiltrating the abdominal musculature causing micro abscess formation. Colonoscopy was inconclusive as the growth was not passable enough to obtain enough biopsy for pathology. The patient underwent surgery for removal of tumor and the histopathology revealed the squamous cell carcinoma. Through the course of patient's recovery in hospital thorough evaluation was done to identify primary in sites mainly the urogenital tract. The patient was discharged and unfortunately succumbed to her disease at home before definitive treatment could be given. CONCLUSION Squamous cell carcinomas in the colon warrants extensive search for the primary and coexistent adenocarcinomas or ulcerative colitis. In patients who recover from surgery, chemoradiation directed towards the pathology should be initiated to prevent rapid deterioration as in our case. Its presentation may be exophytic infiltrating surrounding structures and micro abscesses or perforations may also be encountered. We add our case report to the existing literature of primary squamous cell colon carcinoma series.
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Cheregi CD, Simon I, Fabian O, Maghiar A. Mechanical suture in rectal cancer. Med Pharm Rep 2017; 90:305-312. [PMID: 28781527 PMCID: PMC5536210 DOI: 10.15386/cjmed-787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/19/2017] [Accepted: 06/26/2017] [Indexed: 12/23/2022] Open
Abstract
Background and aims Colorectal cancer is one of the most frequent digestive malignancies, being the third cause of death by cancer, despite early diagnosis and therapeutic progress made over the past years. Standard treatment in these patients is to preserve the anal sphincter with restoration of intestinal function by mechanical colorectal anastomosis or coloanal anastomosis, and to maintain genitourinary function by preservation of hypogastric nerves. Methods In order to emphasize the importance of this surgical technique in the Fourth Surgical Clinic of the CF Clinical Hospital Cluj-Napoca, we conducted a prospective observational interventional study over a 3-year period (2013–2016) in 165 patients hospitalized for rectal and rectosigmoid adenocarcinoma in various disease stages, who underwent Dixon surgery using the two techniques of manual and mechanical end-to-end anastomosis. For mechanical anastomosis, we used Covidien and Panther circular staplers. The patients were assigned to two groups, group A in which Dixon surgery with manual end-to-end anastomosis was performed (116 patients), and group B in which Dixon surgery with mechanical end-to-end anastomosis was carried out (49 patients). Results Mechanical anastomosis allowed to restore intestinal continuity following low anterior resection in 21 patients with lower rectal adenocarcinoma compared to 2 patients in whom intestinal continuity was restored by manual anastomosis, with a statistically significant difference (p<0.000001). The double-row mechanical suture technique is associated with a reduced duration of surgery (121.67 minutes for Dixon surgery with mechanical anastomosis, compared to 165.931 minutes for Dixon surgery with manual anastomosis, p<0.0001). Conclusion The use of circular transanal staplers facilitates end-to-end anastomosis by double-row mechanical suture, allowing to perform low anterior resection in situations when the restoration of intestinal continuity by manual anastomosis is technically not possible, with the aim to preserve the anal sphincter, to restore intestinal function and maintain genitourinary function through preservation of hypogastric nerves.
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Affiliation(s)
| | - Ioan Simon
- Department of Surgery, Railway Company University, Cluj-Napoca, Romania
| | - Ovidiu Fabian
- Department of Surgery, Railway Company University, Cluj-Napoca, Romania
| | - Adrian Maghiar
- Department of Surgery, Pelican Hospital, Oradea, Romania
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Chiu MS, Verma V, Bennion NR, Bhirud AR, Li J, Charlton ME, Are C, Lin C. Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma. Cancer Med 2016; 5:3394-3402. [PMID: 27781400 PMCID: PMC5224838 DOI: 10.1002/cam4.927] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/02/2016] [Accepted: 09/04/2016] [Indexed: 12/29/2022] Open
Abstract
Large, population-based analyses of rectal squamous cell carcinoma (SCC) have not been previously conducted. We assessed patterns of care, prognostic factors, and outcomes of rectal SCC and adenocarcinoma (AC) in population-based cohorts. Surveillance, Epidemiology, and End Results (SEER) registry searches were performed (1998-2011), producing 42,308 nonmetastatic rectal cancer patients (999 SCC and 41,309 AC). Patient, tumor, and treatment characteristics were compared. Based on risk factors, SCC/AC groups were subdivided into low-, intermediate-, and high-risk groups. Overall survival (OS) was compared between histological and risk groups using Kaplan-Meier method and log-rank test. Multivariate logistic regression models evaluated prognostic factors for 5-year survival. Cox regression modeling was performed on propensity-matched data. Rectal SCC, more common in females and associated with larger tumors of higher grade, was more often treated with radiotherapy (RT) than surgery. Surgery was associated with higher OS in AC but not SCC, and RT had proportionally greater benefits in SCC. These effects of RT and surgery were retained when stratified into risk groups (particularly high/intermediate-risk). Favorable prognostic factors for survival included younger age, non-black race, SCC histology, size ≤3.9 cm, localized stage, lower grade, surgery, and RT. For SCC, race, tumor grade, and surgery were not prognostic factors for survival. Cox regression modeling of propensity-matched data showed that AC histology increased risk of death versus SCC. In the largest analysis of rectal SCC to date, and in the notable absence (and unlikelihood) of prospective data, nonsurgical and RT-based treatment is recommended.
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Affiliation(s)
- Max S Chiu
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Vivek Verma
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Nathan R Bennion
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Abhijeet R Bhirud
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jinluan Li
- Department of Radiation Oncology, Fujian Cancer Hospital, Fuzhou, China
| | - Mary E Charlton
- University of Iowa College of Public Health, VA Center for Comprehensive Access & Delivery Research & Evaluation, Iowa City, Iowa
| | - Chandrakanth Are
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Chi Lin
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
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7
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Guerra GR, Kong CH, Warrier SK, Lynch AC, Heriot AG, Ngan SY. Primary squamous cell carcinoma of the rectum: An update and implications for treatment. World J Gastrointest Surg 2016; 8:252-265. [PMID: 27022453 PMCID: PMC4807327 DOI: 10.4240/wjgs.v8.i3.252] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/03/2015] [Accepted: 01/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma (SCC).
METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.
RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC’s are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-node-metastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external site of primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies have demonstrated a global shift away from surgery towards definitive chemoradiotherapy as primary treatment. Pooled overall survival was calculated to be 86% in patients managed with chemoradiation compared with 48% for those treated traditionally with surgery. Furthermore, local recurrence and metastatic rates were 25% vs 10% and 30% vs 13% for the chemoradiation vs conventional treatment cohorts.
CONCLUSION: The changing paradigm in the treatment of rectal SCC holds great promise for improved outcomes in this rare disease.
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Ballestero Pérez A, Abadía Barnó P, García-Moreno Nisa F, Die Trill J, Galindo Álvarez J. Primary squamous cell carcinoma of the rectum: an atypical histology. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016; 108:826-835. [PMID: 26911877 DOI: 10.17235/reed.2016.3975/2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Squamous cell carcinoma of the rectum is one of the differential diagnoses of rectal tumors. It represents a low incidence in the population. The etiopathogenesis and the biology of these tumors are unclear, for this reason the gold standard treatment is difficult to establish. We present a 47-years-old woman who had a squamous cell carcinoma in medium rectum. She was treated with radiation therapy and chemotherapy and the treatment was followed by surgical excision.
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Affiliation(s)
| | - Pedro Abadía Barnó
- Cirugía General y Digestivo, Hospital Universitario Ramón y Cajal. Madrid, España
| | | | - Javier Die Trill
- Cirugía General, Hospital Universitario Ramón y Cajal. Madrid, españa
| | - Julio Galindo Álvarez
- Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal. Madrid, ESPAÑA
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Sundriyal D, Shirsi N, Kotwal S, Dawar R. Squamous Cell Carcinoma of Rectum: How to Treat? Indian J Surg Oncol 2015; 6:300-2. [PMID: 27217685 DOI: 10.1007/s13193-015-0434-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 06/15/2015] [Indexed: 11/27/2022] Open
Abstract
Squamous cell carcinoma (SCC) of rectum is an uncommonly seen malignancy. It has been difficult to establish the precise etio-pathogenesis due to paucity of cases. For the same reason, the rigorous treatment protocol has not been defined. The available compendium of knowledge about this pathology is based on isolated case reports and case series. We report a case of SCC of rectum who was treated with chemo-radiotherapy.
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Affiliation(s)
- Deepak Sundriyal
- Department of Medical Oncology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India ; 79 , Sector 12, Dwarka, New delhi 110078 India
| | - Nikhil Shirsi
- Department of Medical Oncology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India
| | - Sumedha Kotwal
- Department of Pathology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India
| | - Ramesh Dawar
- Department of Pathology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India
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Musio D, De Felice F, Manfrida S, Balducci M, Meldolesi E, Gravina GL, Tombolini V, Valentini V. Squamous cell carcinoma of the rectum: The treatment paradigm. Eur J Surg Oncol 2015; 41:1054-8. [PMID: 25956212 DOI: 10.1016/j.ejso.2015.03.239] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 03/17/2015] [Accepted: 03/30/2015] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study was planned to clarify the optimal treatment for squamous cell carcinoma of the rectum, an histological entity extremely rare. METHODS Ten patients with histologically proven squamous cell carcinoma of the rectum were treated with concomitant radiochemotherapy. Radiation therapy was delivered with a 3Dconformational multiple field technique to a dose ranging from 45 to 76.5 Gy, with 6-15 MV energy photons. Chemotherapy consisted of an antimetabolite drug in association with mitomycin C or oxaliplatin. Overall survival and disease free survival were considered in months from the end of the concomitant treatment. RESULTS All patients completed programmed radiochemotherapy treatment but two patients were excluded to the analysis. Six patients (75%) presented negative biopsy 6 months after the end of radiochemotherapy. Seven patients (87.5%) showed a tumour regression after initial treatment. Only 1 patient underwent salvage surgery. Considering a mean follow-up of 41.75 months, 7 patients are still disease free survivors. Only 1 patient developed local recurrence at 6 months and he died 14 months after abdomino-perineal resection. CONCLUSION Primary radio chemotherapy, with a curative intent, could be considered the treatment modality of choice for squamous carcinoma of the rectum.
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Affiliation(s)
- D Musio
- Department of Radiotherapy, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy.
| | - F De Felice
- Department of Radiotherapy, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy
| | - S Manfrida
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - M Balducci
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - E Meldolesi
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - G L Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - V Tombolini
- Department of Radiotherapy, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy
| | - V Valentini
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
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Puga Bermúdez R, Ramia JM, de la Plaza Llamas R, Sabater Maroto C, García Fernández E. [Adenosquamous and squamous carcinomas of the colon and rectum]. GASTROENTEROLOGIA Y HEPATOLOGIA 2015; 38:283-5. [PMID: 24837043 DOI: 10.1016/j.gastrohep.2014.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 03/30/2014] [Accepted: 03/31/2014] [Indexed: 02/07/2023]
MESH Headings
- Abdomen, Acute/etiology
- Aged
- Aged, 80 and over
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Adenosquamous/surgery
- Carcinoma, Adenosquamous/therapy
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Carcinoma, Squamous Cell/therapy
- Chemotherapy, Adjuvant
- Colonic Neoplasms/pathology
- Colonic Neoplasms/surgery
- Colonic Neoplasms/therapy
- Combined Modality Therapy
- Fatal Outcome
- Gastrointestinal Hemorrhage/etiology
- Humans
- Male
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Multiple Primary/therapy
- Pneumoperitoneum/etiology
- Radiotherapy, Adjuvant
- Rectal Neoplasms/pathology
- Rectal Neoplasms/surgery
- Rectal Neoplasms/therapy
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Affiliation(s)
- Ramón Puga Bermúdez
- Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
| | - José Manuel Ramia
- Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España.
| | - Roberto de la Plaza Llamas
- Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
| | - Cristina Sabater Maroto
- Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, España
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Squamous cell carcinoma of the middle rectum: Report of a case and literature overview. Int J Surg Case Rep 2014; 7C:127-9. [PMID: 25465645 PMCID: PMC4336389 DOI: 10.1016/j.ijscr.2014.10.097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/25/2014] [Accepted: 10/29/2014] [Indexed: 12/18/2022] Open
Abstract
We report a case of squamous cell carcinoma of middle rectum, with literature review (International Journal of Surgery Case Reports 2014; 5: 86–90). The report we describe was characterized by the presence of a squamous cell carcinoma of the middle rectum and a synchronous ureteral tumor. The patient had undergone pelvic irradiation for prostate cancer seven years before, thus suggesting aforementioned treatment as possible cause.
INTRODUCTION Squamous-cell carcinoma (SCC) of the middle rectum is a rare disease with an estimated incidence of 0.1–0.25/1000 colorectal neoplasms. Literature is represented essentially by case report and short series, and only seventy-six cases of colorectal squamous carcinoma have been documented in literature. PRESENTATION OF CASE We report the case of a SCC of the middle rectum, associated to an ureteral inverted papilloma, occurred in a patient with a past history of prostate cancer treated with prostatectomy and radiotherapy. DISCUSSION Colorectal squamous-cell carcinoma is a rare disease. This localization is more frequent than the right colon, but no more epidemiological informations are actually available apart from a slight predominance of the female sex. Risk factors for SCC of the rectum are unknown and many hypotheses have been evocated. Because of its rarity, the interpretation of available information is clouded by a lack of uniformity in diagnosis and treatment. CONCLUSION Treatment of SCC remains very challenging, and the acquisition of more consistent data is needed.
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13
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Wang JF, Wang ZX, Xu XX, Wang C, Liu JZ. Primary rectal squamous cell carcinoma treated with surgery and radiotherapy. World J Gastroenterol 2014; 20:4106-4109. [PMID: 24744603 PMCID: PMC3983470 DOI: 10.3748/wjg.v20.i14.4106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/13/2014] [Accepted: 03/06/2014] [Indexed: 02/06/2023] Open
Abstract
Primary squamous cell carcinoma of the rectum is a rare malignancy, and the discrete dual lesions of rectum are even rarer. There is currently no effective and satisfactory treatment for this disease. Here we report a case of an elderly female with bi-primary squamous cell carcinoma of the rectum treated with radical resection and radiotherapy. The patient is still alive 43 mo after the initial curative resection of the tumor. We suggest that surgery as the primary treatment followed by concomitant radiotherapy may be an effective protocol for elderly patients with rectal squamous cell carcinoma.
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14
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Kassir R, Baccot S, Bouarioua N, Petcu CA, Dubois J, Boueil-Bourlier A, Patoir A, Epin A, Ripamonti B, Tiffet O. Squamous cell carcinoma of middle rectum: Literature review. Int J Surg Case Rep 2013; 5:86-90. [PMID: 24441443 DOI: 10.1016/j.ijscr.2013.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 12/16/2013] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Squamous cell carcinoma SCC of the rectum is a distinct entity. We report a very rare case of squamous cell carcinoma of the middle rectum. PRESENTATION OF CASE The patient was a 62-year-old woman who presented with a history of rectal bleeding and discomfort. Colonoscopy revealed a polypoid tumour of the middle rectum. Biopsies of this mass revealed a poorly differentiated SCC of the rectum. CT scan of the chest, abdomen and pelvis was negative for distal metastases. The patient received combined chemo-radiation followed by surgical excision. The postoperative period was uncomplicated. DISCUSSION The pathogenesis of rectal SCC remains unclear and diagnosis is often delayed. Diagnostic criteria have been proposed. MRI of the rectum and trans-rectal endoscopic ultrasound R-EUS provide essential information to plan a therapeutic approach. The squamous cell carcinoma antigen level is not suitable for initial diagnosis of rectal SCC. Most authors conclude that the surgery is the gold standard treatment. Tumour stage is the most important prognostic predictor of SCC. CONCLUSION Squamous cell carcinoma of the rectum is a distinct entity. Before the final choice of treatment is made, digestive surgeons should bear in mind this rare tumour.
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Affiliation(s)
- Radwan Kassir
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
| | - Sylviane Baccot
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
| | - Nadia Bouarioua
- Department of Hepato-Gastroenterology, CHU Hospital, Jean Monnet University, Saint Etienne, France
| | - Carmen Adina Petcu
- Department of Pathology, CHU Hospital, Jean Monnet University, Saint Etienne, France
| | - Joelle Dubois
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
| | - Alexia Boueil-Bourlier
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
| | - Arnaud Patoir
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
| | - Antoine Epin
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
| | - Bertrand Ripamonti
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
| | - Olivier Tiffet
- Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France
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15
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[Human papillomavirus type 16- associated primary squamous cell carcinoma of the rectum following cervical intraepithelial neoplasia]. Med Clin (Barc) 2011; 136:223-4. [PMID: 20189202 DOI: 10.1016/j.medcli.2010.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Revised: 12/22/2009] [Accepted: 01/01/2010] [Indexed: 11/24/2022]
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16
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Sameer AS, Syeed N, Chowdri NA, Parray FQ, Siddiqi MA. Squamous cell carcinoma of rectum presenting in a man: a case report. J Med Case Rep 2010; 4:392. [PMID: 21118539 PMCID: PMC3014960 DOI: 10.1186/1752-1947-4-392] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 11/30/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Primary squamous cell carcinomas of the colorectum are very uncommon. Until now, to the best of our knowledge, only 114 cases of squamous cell carcinoma in the colorectum exist in the reported literature. Here we report a case of squamous cell carcinoma of the rectum in the ethnic Kashmiri population in northern India. CASE PRESENTATION The case of a 60-year-old male patient (Asian) with a pure squamous cell carcinoma of the rectum is presented here. The patient underwent a curative surgery with concomitant chemotherapy. Two years after the initial curative resection of the tumor he is still alive. CONCLUSION The prognosis for squamous cell carcinoma of the colorectum is worse than for that of adenocarcinoma, because of the delayed diagnosis. The etiopathogenicity of squamous cell carcinoma of the colorectum is discussed. Surgical resection of the lesion seems to be the treatment of choice. Chemotherapy also helps in improvement of the prognosis.
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Affiliation(s)
- A Syed Sameer
- Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 90011, India
- Department of Clinical Biochemistry, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190011, India
- Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190011, India
| | - Nidda Syeed
- Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 90011, India
| | - Nissar A Chowdri
- Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190011, India
| | - Fazl Q Parray
- Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 190011, India
| | - Mushtaq A Siddiqi
- Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, 90011, India
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17
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Iannacone E, Dionisi F, Musio D, Caiazzo R, Raffetto N, Banelli E. Chemoradiation as definitive treatment for primary squamous cell cancer of the rectum. World J Radiol 2010; 2:329-33. [PMID: 21160687 PMCID: PMC2999332 DOI: 10.4329/wjr.v2.i8.329] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 06/29/2010] [Accepted: 07/06/2010] [Indexed: 02/06/2023] Open
Abstract
In this report, we present a case of advanced squamous cell cancer located in the rectum of a 78-year-old woman treated with chemoradiation with curative intent. The patient showed a complete clinical response to chemoradiation; multiple biopsies were performed at the site of the previous mass 5 mo after the end of treatment and histological examination showed no residual tumour in the specimens. Surgical intervention was avoided and the patient was free of disease 12 mo after the diagnosis of cancer. Primary chemoradiation should be considered as the treatment of choice for this rare malignancy.
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18
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Al Hallak MN, Hage-Nassar G, Mouchli A. Primary Submucosal Squamous Cell Carcinoma of the Rectum Diagnosed by Endoscopic Ultrasound: Case Report and Literature Review. Case Rep Gastroenterol 2010; 4:243-249. [PMID: 20805951 PMCID: PMC2929423 DOI: 10.1159/000319013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Primary colorectal squamous cell carcinoma (SCC) is one of the very rare malignancies of the gastrointestinal tract. The diagnosis cannot be made before ruling out other common primary sites. Using the endoscopic ultrasound (EUS) technique to get a tissue biopsy for submucosal tumors has not been demonstrated as the best diagnostic approach in the literature. Surgery is the gold standard treatment with arising evidence of good efficacy following conventional chemoradiation therapy. A 49-year-old male presented with rectal discomfort. Sigmoidoscopy revealed multiple submucosal masses in the rectosigmoid colon. Mucosal biopsies showed nonspecific inflammation. Subsequently, an EUS with fine needle biopsy was done and established the diagnosis of rectal SCC. There were no other primary sites noticed in the extensive evaluation. The patient chose to be treated only with chemoradiation without surgery. At the time of writing this report he had no evidence of recurrence achieving 2.5 years of survival. EUS is an emerging excellent approach to diagnose submucosal colorectal SCC. This case will add supportive evidence of having a complete response following combining treatment with squamous cell directed chemotherapy and external beam radiotherapy without preceded surgery.
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19
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20
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Ghigna MR, Drak Alsibai K, Porras J, Palazzo L, Godchaux JM, Fabre M. Deep-seated rectal/anal basaloid carcinoma: useful immunocytochemistry in rare squamous cell carcinoma variants. Cytopathology 2009; 20:315-20. [DOI: 10.1111/j.1365-2303.2008.00560.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Abstract
Squamous cell carcinoma of the rectum is a rare malignancy. It appears to be associated with chronic inflammatory conditions and infections. The clear association seen between Human Papilloma Virus and various squamous cancers has not been firmly established for the squamous cell cancer of the rectum. The presentation is nonspecific and patients tend to present with advanced stage disease. Diagnosis relies on endoscopic examination with biopsy of the lesion. Distinction from squamous cell cancer of the anus can be difficult, but can be facilitated by immunohistochemical staining for cytokeratins. Staging of the cancer with endoscopic ultrasound and computed tomography provides essential information on prognosis and can guide therapy. At present, surgery remains the main therapeutic option; however recent advances have made chemoradiation a valuable therapeutic addition. Squamous cell carcinoma of the rectum is a distinct entity and it is of crucial importance for the practicing Gastroenterologist to be thoroughly familiar with this disease. Compared to adenocarcinoma of the rectum and squamous cell cancer of the anal canal, squamous cell carcinoma of the rectum has different epidemiology, etiology, pathogenesis, and prognosis but, most importantly, requires a different therapeutic approach. This review will examine and summarize the available information regarding this disease from the perspective of the practicing gastroenterologist.
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22
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Leung KK, Heitzman J, Madan A. Squamous cell carcinoma of the rectum 21 years after radiotherapy for cervical carcinoma. Saudi J Gastroenterol 2009; 15:196-8. [PMID: 19636183 PMCID: PMC2841421 DOI: 10.4103/1319-3767.54745] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the rectum is an extremely rare malignancy, accounting for 0.1-0.2% of rectal malignancies. It is associated with ulcerative colitis, prior radiation, schistosomiasis, ovarian cancer, endometrial cancer, human papilloma virus, colocutaneous fistulas and colonic duplication. Prior reported cases of SCC of the rectum have involved treatment with brachytherapy and external beam radiation. This case is particularly interesting because of the remote exposure of radiation (21 years previously) and the subsequent development of SCC of the rectum. Although extremely rare, SCC of the rectum can occur decades after radiation exposure.
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Affiliation(s)
- Kevin K. Leung
- Department of Gastroenterology, The University of Texas Health Science Center, Houston, TX 77030, USA
| | - Joseph Heitzman
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, TX 77030, USA
| | - Anand Madan
- Department of Gastroenterology, The University of Texas Health Science Center, Houston, TX 77030, USA,Address for correspondence: Dr. Anand Madan, Division of Gastroenterology, The University of Texas Health Science Center, 6431 Fannin Street, MSB 4.234, Houston, TX 77030, USA. E-mail:
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23
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Primary adenosquamous carcinoma of the colon: report of five cases. Surg Today 2009; 39:619-23. [PMID: 19562453 DOI: 10.1007/s00595-008-3884-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 10/24/2008] [Indexed: 12/17/2022]
Abstract
Primary adenosquamous cell carcinomas (Ad-SCCs) of the colon and rectum are rare malignancies with a poor prognosis, in comparison to adenocarcinoma alone. Different roles of human papilloma virus (HPV) in its pathogenesis have been reported and the role of P16 in Ad-SCCs has not been explored. This report presents five cases of Ad-SCC of the colon to explore the clinicopathological features and the roles of P16, HPV 6/11, and 16/18. There was no confirmed evidence to support the relationship between the infection of HPV 6/11, 16/18, and pathogenesis of Ad-SCC of the colon. P16 overexpression was not related to HPV carcinogenesis and there might be another mechanism of P16 upregulation in Ad-SCC of the colon.
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24
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Adán Merino L, Gea Rodríguez F, Gómez Senent S, Martín Arranz E, Alonso Gamarra E, Segura Cabral JM. [Squamous cell carcinoma of the rectum in a patient with HIV infection]. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 32:535-6. [PMID: 19539403 DOI: 10.1016/j.gastrohep.2009.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 02/10/2009] [Indexed: 10/20/2022]
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25
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Brammer RD, Taniere P, Radley S. Metachronous squamous-cell carcinoma of the colon and treatment of rectal squamous carcinoma with chemoradiotherapy. Colorectal Dis 2009; 11:219-20. [PMID: 18477022 DOI: 10.1111/j.1463-1318.2008.01577.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Rectal squamous-cell carcinoma is a rare tumour with an incidence of less than 1 per 1000 cases. We report such a case treated with chemoradiotherapy. The patient developed a metastasis in the spleen and a further squamous tumour in the right colon, both of which were successfully resected. No histological evidence of recurrent rectal tumour has been found. Two years following presentation, the patient remains disease-free although symptomatic from a radiotherapy-induced stricture of the rectum.
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Affiliation(s)
- R D Brammer
- Department of Surgery, University Hospital, Birmingham NHS Foundation Trust, Queen Elizabeth Medical Centre, Birmingham, West Midlands, UK
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26
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Rasheed S, Yap T, Zia A, McDonald PJ, Glynne-Jones R. Chemo-radiotherapy: an alternative to surgery for squamous cell carcinoma of the rectum--report of six patients and literature review. Colorectal Dis 2009; 11:191-7. [PMID: 18462236 DOI: 10.1111/j.1463-1318.2008.01560.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Since 1943 [1], only 45 patients of squamous cancer of the rectum have been reported in the published reports and the largest series to date consists of 12 patients. Reports suggest that the primary treatment is surgical resection but, in the light of nonsurgical advances in the treatment of anal squamous cell carcinoma (SCC), we present a review of the literature and report six patients treated by chemoradiation therapy (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 CRT in rectal SCC. A prospective database of the Mount Vernon Cancer Centre, UK was searched from 1995 to 2005 for patients diagnosed with pure SCC of the rectum. RESULTS Six patients with histologically confirmed primary SCC of the rectum were treated with primary combination chemo-radiotherapy according to protocols used for SCC of the anal canal over a 15-year period. Surgery was avoided in four, and they remain disease-free on follow-up. CONCLUSIONS Primary CRT, as currently utilized in anal cancer, can be extended to primary SCC of the rectum.
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Affiliation(s)
- S Rasheed
- Northwick Park and St Mark's Hospitals, Harrow, Middlesex, UK
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27
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Gatlez J, Hendlisz A, Legendre H, Sirtaine N, Debroux S, Awada A. [Colorectal epidermoid carcinoma and paraneoplastic hypercalcemia]. Acta Clin Belg 2007; 62:433-7. [PMID: 18351188 DOI: 10.1179/acb.2007.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The squamous cell carcinoma and the adenosquamous cell carcinoma of the colon and rectum are not well know and rare tumours. We report a case of squamous cell carcinoma of the recto-sigmoid who relapses in the liver after surgery of the primary tumour with paraneoplasic hypercalcaemia. We will discuss the pathogenesis, prognosis, associated conditions, clinical features and treatment strategies of squamous and adenosquamous cell carcinoma of the colon and the rectum.
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Affiliation(s)
- J Gatlez
- Institut Jules Bordet, Bruxelles, Belgique.
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28
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Theodosopoulos TK, Marinis AD, Dafnios NA, Vassiliou JG, Samanides LD, Carvounis EE, Smyrniotis VE. Aggressive treatment of metastatic squamous cell carcinoma of the rectum to the liver: a case report and a brief review of the literature. World J Surg Oncol 2006; 4:49. [PMID: 16895595 PMCID: PMC1555584 DOI: 10.1186/1477-7819-4-49] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Accepted: 08/08/2006] [Indexed: 12/13/2022] Open
Abstract
Background Rectal squamous cell carcinoma (SCC) is a rare tumor. The incidence of this malignancy has been reported to be 0.25 to 1 per 1000 colorectal carcinomas. From a review of the English literature 55 cases of SCC of the rectum have been published. In this study we report a rectal metastatic SCC to the liver, discussing the efficacy of aggressive adjuvant and neo-adjuvant therapies on survival and prognosis. Case presentation A 39-year-old female patient with a pure SCC of the rectum diagnosed endoscopically is presented. The patient underwent initially neoadjuvant chemo-radiotherapy and then abdominoperineal resection with concomitant bilateral oophorectomy and hysterectomy, followed by adjuvant chemo-radiotherapy. Five months after the initial operation liver metastasis was demonstrated and a liver resection was carried out, followed by adjuvant chemotherapy. Eighteen months after the initial operation the patient is alive. Conclusion Although prognosis of rectal SCC is worse than that of adenocarcinoma, an aggressive therapeutic approach with surgery as the primary treatment, followed by combined neo- and adjuvant chemo-radiotherapy, may be necessary in order to improve survival and prognosis.
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Affiliation(s)
- Theodosios K Theodosopoulos
- Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
| | - Athanasios D Marinis
- Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
| | - Nikolaos A Dafnios
- Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
| | - John G Vassiliou
- Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
| | - Lazaros D Samanides
- Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
| | - Eleni E Carvounis
- Department of Pathology, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
| | - Vassilios E Smyrniotis
- Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av., 11528, Athens, Greece
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29
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Dogu GG, Ozkan M, Er O, Eser B, Altinbas M. Squamous cell carcinoma of colorectal cancer: adjuvant radiotherapy is necessary? Eur J Cancer Care (Engl) 2005; 14:465. [PMID: 16274470 DOI: 10.1111/j.1365-2354.2005.00613.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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