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Revista Espanola de Enfermedades... Feb 2022The association between inflammatory bowel disease (IBD) and anal canal squamous cell carcinoma (SCC) has a low prevalence and is mainly supported by articles that...
The association between inflammatory bowel disease (IBD) and anal canal squamous cell carcinoma (SCC) has a low prevalence and is mainly supported by articles that include a series of cases. We describe the clinical, endoscopic and histological findings of a patient with Crohn's disease (CD) who developed SCC while undergoing biological therapy with active disease.
Topics: Anus Neoplasms; Carcinoma, Squamous Cell; Crohn Disease; Humans; Inflammatory Bowel Diseases
PubMed: 34555919
DOI: 10.17235/reed.2021.8317/2021 -
Diseases of the Colon and Rectum Dec 2020Anorectal stricturing is a particularly morbid manifestation of Crohn's disease resulting in a diminished quality of life related to pain, incontinence, and recurrent... (Review)
Review
BACKGROUND
Anorectal stricturing is a particularly morbid manifestation of Crohn's disease resulting in a diminished quality of life related to pain, incontinence, and recurrent operative interventions.
OBJECTIVE
To determine the role of medical therapy, endoscopic dilation, and surgical intervention for the treatment of isolated anorectal stricturing.
DATA SOURCES
An organized search of MEDLINE, PubMed, EMBASE, Scopus, and the Cochrane Database of Collected Reviews was performed from January 1, 1990 through May 1, 2020.
STUDY SELECTION
Full text papers which included management of isolated anorectal strictures in the setting of Crohn's disease.
INTERVENTION(S)
Medical and surgical management.
MAIN OUTCOME MEASURES
Symptomatic relief, need for proctocolectomy.
RESULTS
Our search identified a total of 553 papers; after exclusion based on title (n = 430) and abstract (n = 47), 76 underwent full text review with 65 relevant to the management of anorectal strictures. A summary of the retrospective reports suggests that medical therapy can help control luminal inflammation, but fibrosis may ultimately set in resulting in a need for endoscopic or surgical intervention. Surgical options are limited in the anal canal due to inflammation and ulceration and concomitant perianal fistulizing disease. While fecal diversion can provide symptomatic relief, successful restoration of intestinal continuity remains uncommon and most patients ultimately undergo a total proctocolectomy with end ileostomy.
LIMITATIONS
Limited literature published, all retrospective in nature.
CONCLUSIONS
Despite significant advances in medical and surgical therapy in Crohn's disease over the last decades, there is clearly an unmet need in the management of anorectal strictures in Crohn's disease.
Topics: Anus Diseases; Biological Therapy; Constriction, Pathologic; Crohn Disease; Dilatation; Disease Management; Endoscopy; Female; Humans; Ileostomy; Proctocolectomy, Restorative; Quality of Life; Retrospective Studies; Treatment Outcome
PubMed: 33149025
DOI: 10.1097/DCR.0000000000001834 -
Gastrointestinal Endoscopy Clinics of... Oct 2022Crohn disease (CD) patients can develop fistula or abscess from persistent active disease or postsurgical complications. Penetrating CD is traditionally treated with... (Review)
Review
Crohn disease (CD) patients can develop fistula or abscess from persistent active disease or postsurgical complications. Penetrating CD is traditionally treated with medication and surgery. The role of medication alone in the treatment of fistula is limited, except perianal fistulas or enterocutaneous fistula. Surgery is the standard treatment in those with hollow-organ to hollow-organ fistula, like ileovesicular fistula. Surgery is invasive with a higher risk of postoperative complications. Endoscopic therapy has evolved as a valid option. Fistulotomy, surgical or endoscopic, should be considered first-line therapy when feasible. Incision and drainage of perianal abscesses with an endoscopic device may be attempted.
Topics: Abscess; Anus Diseases; Crohn Disease; Humans; Intestinal Fistula; Rectal Fistula; Treatment Outcome
PubMed: 36202513
DOI: 10.1016/j.giec.2022.05.006 -
Missouri Medicine 2020Anorectal conditions are one of the most common problems evaluated by primary care physicians. Most patients present with rectal pain, rectal bleeding, or purulent... (Review)
Review
Anorectal conditions are one of the most common problems evaluated by primary care physicians. Most patients present with rectal pain, rectal bleeding, or purulent drainage per rectum. Colorectal conditions have overlapping symptoms. Thorough history and careful anorectal examination can differentiate common anorectal conditions like hemorrhoids, anorectal abscesses, anal fistula, anal fissure, and anal condyloma. Most of these conditions can be diagnosed and treated without imaging.
Topics: Anus Diseases; Colorectal Surgery; Diagnosis, Differential; Fissure in Ano; Hemorrhoids; Humans; Primary Health Care
PubMed: 32308242
DOI: No ID Found -
Journal of Magnetic Resonance Imaging :... Oct 2019The normal function of the anal sphincter complex is crucial for quality of life, as it is the mechanism by which fecal continence is maintained. Additionally, the anal... (Review)
Review
The normal function of the anal sphincter complex is crucial for quality of life, as it is the mechanism by which fecal continence is maintained. Additionally, the anal sphincter complex is an integral part of the coordinated effort of defecation. As imaging plays an important role in assessment of pathologic conditions involving the anal region, understanding the normal anatomy of the anal sphincter complex is important for correct image interpretation and accurate diagnosis. This review discusses the anatomy and function of the anal sphincter complex, important technical considerations for MRI, and various inflammatory, infectious, and neoplastic processes, as well as pathologic structural conditions that affect the anal region. Level of Evidence: 5 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:1018-1032.
Topics: Anal Canal; Anus Diseases; Humans; Magnetic Resonance Imaging
PubMed: 31115134
DOI: 10.1002/jmri.26776 -
The British Journal of Surgery Mar 2021This was a cross-sectional and retrospective study of the short-term effects of the COVID-19 pandemic among patients with colorectal or anal cancer treated at AA Camargo... (Observational Study)
Observational Study
This was a cross-sectional and retrospective study of the short-term effects of the COVID-19 pandemic among patients with colorectal or anal cancer treated at AA Camargo Cancer Centre, a large and comprehensive cancer centre located in Sao Paulo, the epicentre of the pandemic in Brazil. The aim was to quantify the barriers to access to treatment and diagnosis of these tumours during the pandemic in comparison with the previous year. The results showed a significant decrease in newly diagnosed patients with colorectal or anal cancer, a significant increase in patients with locally advanced disease at presentation, and an increase in the proportion of patients without insurance for coverage of costs.
Topics: Adult; Aged; Aged, 80 and over; Anus Neoplasms; Brazil; COVID-19; Colorectal Neoplasms; Cross-Sectional Studies; Early Detection of Cancer; Female; Health Services Accessibility; Humans; Male; Medically Uninsured; Middle Aged; Neoplasm Staging; Referral and Consultation
PubMed: 33711133
DOI: 10.1093/bjs/znaa124 -
Gastroenterology Clinics of North... Mar 2022Painful and bothersome anorectal syndromes can be a diagnostic and therapeutic challenge for clinicians because structural and functional abnormalities may often coexist... (Review)
Review
Painful and bothersome anorectal syndromes can be a diagnostic and therapeutic challenge for clinicians because structural and functional abnormalities may often coexist and require a multidisciplinary approach to management. Although it is often difficult to attribute all of a patient's anorectal symptoms to a singular disorder with definitive intervention and cure, improving quality of life, treating coexistent conditions such as functional constipation and/or defecation disorders, addressing psychological comorbidities if present, and confirming there is no evidence of inflammatory or malignant conditions are top priorities.
Topics: Anal Canal; Anus Diseases; Constipation; Fistula; Hemorrhoids; Humans; Pain; Quality of Life; Syndrome
PubMed: 35135658
DOI: 10.1016/j.gtc.2021.10.008 -
Journal of Clinical Virology : the... Jul 2023Human papillomavirus associated anogenital cancers are a significant global burden. The detection of biomarkers (circulating tumour DNA; ctDNA or circulating HPV DNA;... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Human papillomavirus associated anogenital cancers are a significant global burden. The detection of biomarkers (circulating tumour DNA; ctDNA or circulating HPV DNA; cHPV DNA) in blood referred to as "liquid biopsy" may support the early diagnosis and monitoring of affected individuals.
METHODS
A systematic review, including meta-analysis of studies available in the literature on the utilization of ctDNA and cHPV DNA as diagnostic, predictive, and monitoring biomarker tests of HPV associated anogenital cancers was performed following the criteria of PRISMA.
RESULTS
A total of 31 studies were eligible for systematic review; 20 used cHPV DNA in cervical cancers; 7 used ctDNA in cervical cancer; 5 used cHPV DNA in anal cancer; no eligible studies on vulva, vaginal or penile cancer were available. The meta-analysis identified low sensitivity (0.36) and high specificity (0.96) of cHPV DNA as diagnostic for cervical cancer. Comparatively, there was high sensitivity (0.95) and specificity (1.0) of cHPV DNA for the diagnosis of anal cancer. cHPV DNA and/or ctDNA in cervical cancer were prognostic markers associated with poor clinical outcomes. Additionally, in anal cancer the post treatment detection of cHPV DNA was informative in the prediction of treatment response or progression-free survival.
CONCLUSION
ctDNA and cHPV DNA are promising diagnostic and prognostic biomarkers for the detection of anogenital disease. Evolution and refinement of molecular tools is likely to improve performance further. Additionally the comparative absence of studies in the vulval, vaginal and penile context warrants further exploration and research.
Topics: Female; Humans; Uterine Cervical Neoplasms; Papillomavirus Infections; Human Papillomavirus Viruses; Anus Neoplasms; DNA
PubMed: 37163963
DOI: 10.1016/j.jcv.2023.105469 -
Cancer Medicine Jul 2022Anal canal cancer (ACC) has been reported to be an uncommon cancer in Japan, as in the USA, Europe, and Australia. This retrospective multi-institutional study was...
Anal canal cancer (ACC) has been reported to be an uncommon cancer in Japan, as in the USA, Europe, and Australia. This retrospective multi-institutional study was conducted to clarify the characteristics of ACC in Japan. First, the histological ACC type cases treated between 1991 and 2015 were collected. A detailed analysis of the characteristics of anal canal squamous cell carcinoma (SCC) cases was then conducted. The results of the histological types revealed that of the 1781 ACC cases, 435 cases (24.4%) including seven cases of adenosquamous cell carcinomas were SCC and 1260 cases (70.7%) were adenocarcinoma. However, the most common histological type reported in the USA, Europe, and Australia is SCC. Most ACC cases are adenocarcinomas and there is a low incidence of SCC in Japan which is different from the above-mentioned countries. Moreover, we reclassified T4 into the following two groups based on tumor size: T4a (tumor diameter of 5 cm or less) and T4b (tumor diameter of more than 5 cm). The results of the TNM classification of SCC revealed that the hazard ratio (HR) to T1 of T2, T3, T4a, and T4b was 2.45, 2.28, 2.89, and 4.97, respectively. As T4b cases had a worse prognosis than T4a cases, we propose that T4 for anal canal SCC in Japan be subclassified into T4a and T4b.
Topics: Adenocarcinoma; Anal Canal; Anus Neoplasms; Carcinoma, Squamous Cell; Humans; Japan; Retrospective Studies
PubMed: 35274487
DOI: 10.1002/cam4.4631 -
La Revue Du Praticien Sep 2021ANAL CANCER Anal cancer, a rare disease, had increased annual incidence in the recent decades due to high prevalence of HPV. Squamous cell carcinoma is the most frequent...
ANAL CANCER Anal cancer, a rare disease, had increased annual incidence in the recent decades due to high prevalence of HPV. Squamous cell carcinoma is the most frequent histological type and pelvic lymph node invasion is common. However metastatic progression remains unfrequent. Chemoradiotherapy (CRT) is the current standard of care achieving a good loco-regional control, whereas salvage surgery can be proposed in case of treatment failure or local relapse. Better oncological results have been seen given the technological advances in radiotherapy and radiology, whereas chemotherapy has not been modified for 40 years. Personnalized strategies taking into account tumoral staging and patient characteristics as well as immunotherapy are being investigated in current trials. Finally, major advances could come from HPV vaccination.
Topics: Anus Neoplasms; Carcinoma, Squamous Cell; Chemoradiotherapy; Humans; Neoplasm Recurrence, Local; Neoplasm Staging
PubMed: 34792915
DOI: No ID Found