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NCI CANCERLIT^® Search: Anal Cancer - May 2002

Imprima English

National Cancer Institute^®
Ultima Vez Modificado: 1 de mayo del 2002

Impaired sphincter function and good quality of life in anal carcinoma patients after radiotherapy: a paradox?

Perianal rhabdomyosarcoma presenting as a perirectal abscess: A report of 11 cases.

Increased risk of high-grade anal neoplasia associated with a human papillomavirus type 16 E6 sequence variant.

Radiochemotherapy for anal carcinoma - effectivity and late toxicity.

Surgical treatment of high-grade anal squamous intraepithelial lesions: a prospective study.

Activity of HspE7, a novel immunotherapy, in patients with anogenital warts.

Table of Contents

1
UI - 11764655
AU - Vordermark D; Sailer M; Flentje M; Thiede A; Kolbl O
TI - Impaired sphincter function and good quality of life in anal carcinoma patients after radiotherapy: a paradox?
SO - Front Radiat Ther Oncol 2002;37():132-9
AD - Department of Radiation Oncology, University of Wurzburg, Germany. vordermark@strahlentherapie.uni-wuerzburg.de

2
UI - 11912514
AU - Hill DA; Dehner LP; Gow KW; Pappo AS; Crawford D; Pflaumer SM; Furman
TI - WL; Hayes-Jordan AA; McDermott MB Perianal rhabdomyosarcoma presenting as a perirectal abscess: A report of 11 cases.
SO - J Pediatr Surg 2002 Apr;37(4):576-81
AD - Department of Pathology, St Jude Children's Research Hospital and University of Tennessee, Memphis TN, USA.
BACKGROUND PURPOSE: The organs and soft tissues of the pelvis are some of the most common primary sites for rhabdomyosarcoma (RMS) in children and adolescents. In most cases a mass is detectable on clinical examination, and the initial concern is focused on the possibility of a neoplasm. The current report concerns 11 patients, each presented with a painful perineal-perianal mass suggesting an abscess to the extent that each one of these patients was treated initially with antibiotics or incision and drainage for several weeks to months before the pathologic diagnosis of RMS was established. METHODS: The authors reviewed the clinical histories of all patients with perirectal/perianal RMS from their respective institutions to identify cases in which the initial clinical diagnosis or impression was that of a perirectal abscess. Pathologic material was reviewed in all cases. RESULTS: Eleven patients, 7 of whom were girls, ranged in age from 1 to 16 years at diagnosis (median age, 14 years). Fever accompanied the clinical presentation in 2 patients. None of the patients had a past medical history of illness that may have predisposed them to a perirectal abscess, although one patient had a family history of inflammatory bowel disease. Duration of symptoms ranged from 1 month to 1 year (mean, 4.6 months). Each patient presented with a tender perianal/perineal nodule or mass. Inguinal adenopathy was present in 6 patients at diagnosis. White blood cell counts ranged from 6,600/mm(3) to 24,500/mm(3). LDH levels ranged from 414 to 3,432 U/L. The average time from presentation to pathologic diagnosis of RMS was 2.1 months. Nine of the 11 cases showed an alveolar pattern. All were high-stage disease. Of 7 patients with follow-up longer than 1 year, 2 (29%) are alive without disease. CONCLUSION: This report presents the need to consider the possibility of a malignant neoplasm, in this case RMS, in a child or adolescent with a putative perirectal abscess that fails to respond in the expected manner to incision and drainage and antibiotic therapy. Copyright 2002, Elsevier Science (USA). All rights reserved.

3
UI - 12001039
AU - Da Costa MM; Hogeboom CJ; Holly EA; Palefsky JM
TI - Increased risk of high-grade anal neoplasia associated with a human papillomavirus type 16 E6 sequence variant.
SO - J Infect Dis 2002 May 1;185(9):1229-37
AD - Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.
Expression of the E6 and E7 genes of human papillomavirus (HPV) type 16 have been implicated in the etiology of anogenital premalignant and malignant lesions. To evaluate whether variations in the HPV-16 E6 sequence were related to the incidence of high-grade anal neoplasia, 628 HPV-16-positive anal specimens from 193 human immunodeficiency virus (HIV)-positive and 59 HIV-negative participants were typed for variations in 15 E6 nucleotide positions. Although most participants were infected with a prototype strain, 15 (6%) carried the G131 variant, and 12 (5%) were infected with the Af1a variant. Two new variants not previously reported were identified as well. An elevated risk for high-grade anal squamous intraepithelial lesions was associated with infection by G131 variants, compared with the prototype strain (odds ratio, 3.4; 95% confidence interval, 1.1-10), after controlling for HIV status. These data provide further evidence for HPV strain variation as a factor in determining the natural history of anogenital neoplasia.

4
UI - 11893884
AU - Mai SK; Grieger J; Lachmann R; Bohrer M; Tiefenbacher U; Wenz F
TI - Radiochemotherapy for anal carcinoma - effectivity and late toxicity.
SO - Onkologie 2002 Feb;25(1):55-9
AD - Sektion Strahlentherapie, Institut fur Klinische Radiologie, Universitatsklinikum Mannheim, Germany. sabine.mai@radonk.ma.uni-heidelberg.de
BACKGROUND: Radiochemotherapy of anal carcinoma is an organ-sparing approach with a high curative potential. The purpose was to evaluate the effectivity and late toxicity for patients treated with radiochemotherapy in our department. PATIENTS AND METHODS: During 1990-2000, 27 patients with anal carcinoma were treated at the Universitatsklinikum Mannheim. The median follow-up time was 23 months (max. 68 months). Before treatment, 23 patients were colostomy-free. Patients were treated according to 3 different protocols (Cummings n = 8, EORTC n = 5, RTOG n = 14). Acute toxicity was scored according to the RTOG/EORTC scale, and late toxicity according to the LENT/SOMA scale. RESULTS: 25 patients completed the therapy. One patient died due to leukopenic sepsis, and 1 patient interrupted therapy. 4 patients had a tumor relapse (2 patients immunosuppressed, 1 T4 tumor and 1 recurrence at the field-margin), one underwent abdomino- perineal resection. This resulted in a disease-free survival of about 80% and colostomy-free survival of 90% at 5 years. Total doses < 50 Gy and immunosuppression resulted in higher recurrence rates. Most patients suffered from acute toxicity grades 2 (n = 7) and 3 (n = 19) and late toxicity grades 1 (n = 7) and 2 (n = 4). CONCLUSIONS: Radiochemotherapy for anal carcinoma is an effective therapy with acceptable toxicity. Immunosuppressed patients have a higher risk for tumor recurrences and should be monitored more closely. Copyright 2002 S. Karger GmbH, Freiburg

5
UI - 12006924
AU - Chang GJ; Berry JM; Jay N; Palefsky JM; Welton ML
TI - Surgical treatment of high-grade anal squamous intraepithelial lesions: a prospective study.
SO - Dis Colon Rectum 2002 Apr;45(4):453-8
AD - Department of Surgery, University of California at San Francisco, San Francisco, California, USA.
PURPOSE: The prevalence of anal squamous intraepithelial lesions is high among human immunodeficiency virus-positive homosexual males and, to a lesser extent, among human immunodeficiency virus-negative homosexual males. Furthermore, the incidence of high-grade squamous intraepithelial lesions, the putative precursor lesion to invasive cancer, is also high. We report the first prospective study of high-resolution anoscopy-directed surgical treatment of high-grade squamous intraepithelial lesions. METHODS: A prospective study of patients undergoing surgical treatment of high-grade squamous intraepithelial lesions (excision/cauterization of lesions visualized with high-resolution anoscopy) was performed. Follow-up anoscopy with biopsy and Papanicolaou smear was performed every three to six months. RESULTS: Patients diagnosed with high-grade squamous intraepithelial lesions during the course of their participation in a prospective cohort study of anal squamous intraepithelial lesions were identified. From this group, 37 patients who were treated surgically between 1995 and 1999 were studied. Of these, 29 had tested positive for human immunodeficiency virus and 8 were negative for the virus. Mean patient age was 45 +/- 8 years. Mean duration of follow-up was 32.3 +/- 20.6 months in the human immunodeficiency virus-negative group and 28.6 +/- 12.9 months in the human immunodeficiency virus-positive group. No human immunodeficiency virus-negative patient developed recurrent high-grade squamous intraepithelial lesions. Twenty-three of 29 human immunodeficiency virus-positive patients had persistent or recurrent high-grade squamous intraepithelial lesions (P = 0.003; mean time to recurrence, 12 months). Six patients underwent reoperation for high-grade squamous intraepithelial lesions (4 recurred by 6 months). No patients developed incontinence, stenosis, postoperative infection, or significant bleeding after surgical treatment. CONCLUSIONS: Surgical intervention directed by high-resolution anoscopy is safe and eliminates high-grade squamous intraepithelial lesions in human immunodeficiency virus-negative patients. The high persistence or recurrence rate in human immunodeficiency virus-positive patients suggests that multiple staged procedures and continued surveillance may be necessary.

6
UI - 12006932
AU - Goldstone SE; Palefsky JM; Winnett MT; Neefe JR
TI - Activity of HspE7, a novel immunotherapy, in patients with anogenital warts.
SO - Dis Colon Rectum 2002 Apr;45(4):502-7
AD - Mount Sinai School of Medicine, New York, New York, USA.
PURPOSE: Human papillomavirus causes anogenital squamous intraepithelial lesions, warts, and cancer. Treatment of squamous intraepithelial lesions to prevent cancer often requires extensive surgery. We tested a human papillomavirus-specific immunotherapy, HspE7, as a potential alternative. METHODS: HspE7 was constructed by fusing heat shock protein Hsp65 from bacille Calmette-Guerin to E7 protein from human papillomavirus-16. Improvement in pathologic diagnosis of patients with persistent high-grade squamous intraepithelial lesions was studied in an open-label trial (HspE7 500 microg monthly x3). Anogenital warts were not a trial parameter, but a retrospective review of the medical records of the first 22 patients enrolled at one site was undertaken to estimate the quality and frequency of responses of anogenital warts. Patients with warts by physical examination at baseline were scored at 24 weeks as to the percent reduction in wart size. RESULTS: Fourteen of the 22 patients had warts at baseline. At Week 24, 3 of the 14 patients had complete resolution of their warts, and 10 had warts reduced in size an estimated 70 to 95 percent. The remaining patient's warts increased in size. The reduction in size in most patients greatly diminished the procedure necessary for complete ablation. No serious or severe adverse events were related to HspE7. CONCLUSIONS: A retrospective review of patients' medical records suggests that HspE7 may be broadly active in anogenital warts. This activity crosses multiple human papillomavirus types. The warts improved substantially but usually did not totally disappear within six months. Patient follow-up continues. A new randomized, placebo-controlled trial is underway to evaluate these findings.

The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.

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