Practice parameters for anal squamous neoplasms

Summary: This study based on the SEER Program registry data found that patients diagnosed with ASCC are at increased risk of developing SPMs, especially lung, vulva, oropharynx, and colon cancer. Radiation treatment was associated with increased risk for SPMs in the female genital system but appeared protective against prostate cancer as SPMs. Increased surveillance and screening for second malignancies in these patients is recommended as they are often either survivors of a prior cancer diagnosis or at increased risk of developing later malignancies.

Summary: Patients with anal squamous cell carcinoma often experience significant symptoms that require palliative treatments. A study found that only a small proportion of patients required first-line palliative treatments to control symptoms. Palliative radiotherapy was the most frequently used treatment, followed by palliative surgery, chemotherapy, combination therapies, and pain management. Factors associated with the use of first-line palliative therapy included higher stage disease, lower income, Medicare and Medicaid insurance, and life expectancy less than six months.

Summary: Our review presents the experience of eight patients with hepatic-only metastatic squamous cell carcinoma of the anal canal who underwent hepatic resection. The study shows the feasibility and favorable outcomes of a multidisciplinary approach that includes neoadjuvant systemic therapy followed by surgical resection. The results suggest a potential treatment option for patients with limited metastatic disease.

Summary: The study shows that LE is a feasible treatment option for early perianal ASCCs but not for anal canal ASCCs. Acceptable long-term outcomes can still be achieved with adjuvant therapy.

Summary: Anal cancer is a rare disease with increasing incidence rates each year. Significant clinical trials have established the importance of chemotherapy in the treatment of anal cancer. Additionally, the role of immunotherapy in the management of anal cancer is rapidly evolving.

Summary: According to the results of this study, the combined use of PET-CT and MRI for assessing treatment response in anal squamous cell carcinoma (ASCC) after curative-intent chemoradiotherapy (CRT) can better predict patient outcomes and guide personalized patient follow-up.

Summary: Treatment for anal HSIL can significantly reduce the risk of anal cancer in persons living with HIV.

Summary: This systematic review evaluated the efficacy and safety of interventions for anal cancer, finding that primary chemoradiation remains the standard treatment, but further research is needed for treatment options for stage I anal cancer and newer approaches.

Summary: Anal squamous cell carcinoma (SCAC) is a malignancy caused by human papillomavirus (HPV). Due to inadequate HPV vaccination rates, SCAC remains a public health concern. SCAC is usually diagnosed in the local or locoregional setting, where chemoradiation can provide a chance for cure with high control rates. Some patients may experience recurrence or metastatic SCAC. Limited research has been conducted on this rare disease, leading to treatment strategies based on extrapolation from more common squamous cell carcinoma malignancies and small case reports. However, recent years have seen the emergence of dedicated prospective clinical trials focusing on advanced SCAC, providing hope for better management strategies.

Summary: The ANCHOR clinical trial aimed to determine the effectiveness of treating anal high-grade squamous intraepithelial lesions (HSIL) in reducing anal cancer incidence in persons living with HIV. The study successfully developed and validated the ANCHOR Health-Related Symptom Index (A-HRSI) as a patient-reported outcomes (PRO) tool for individuals with anal HSIL. The A-HRSI demonstrated construct validity and responsiveness, making it a potentially valuable instrument for assessing symptoms and impacts related to anal HSIL.

Summary: The efficacy of quantitative parameters derived from dual-energy computed tomography (DECT) for the preoperative prediction of early recurrence (ER) in patients with esophageal squamous cell carcinoma (ESCC) was assessed in this study. The results showed that arterial phase normalized iodine concentration (A-NIC) and pathological grade (PG) were identified as significant risk predictors of ER. A-NIC can be used to noninvasively predict preoperative ER in patients with ESCC, with an efficacy comparable to that of pathological grade.

Summary: The study demonstrated potential therapeutic activity of combination avelumab and cetuximab in patients with aSCAC. However, further research is needed to explore safety and survival outcomes.

Summary: The primary treatment for anal cancer is chemoradiotherapy, but locally advanced cases have a high risk of treatment failure. Induction chemotherapy before radiotherapy may shrink the tumor and improve outcomes. The study presented 20 years of experience with intensified induction chemotherapy for locally advanced anal cancer, suggesting a potential benefit in the most advanced cases.

Summary: Sexual minority men are at increased risk for anal squamous cell carcinoma. Our objective was to compare screening engagement among individuals randomized to self-collect an anal canal specimen at home or to attend a clinic appointment. Specimen adequacy was then assessed for human papillomavirus (HPV) DNA genotyping. A randomized trial recruited cisgendered sexual minority men and transgender people in the community and assigned them to use a home-based self-collection swabbing kit or attend a clinic-based swabbing. Swabs were sent for HPV genotyping. The proportions of participants completing screening in each study arm and the adequacy of their specimens for HPV genotyping were assessed. Relative risks were estimated for factors associated with screening. A total of 240 individuals were randomized. Age (median, 46 years) and HIV status (27.1% living with HIV) did not differ by study arm. A total of 89.2% and 74.2% of home-arm and clinic-arm individuals returned the swab, respectively (P = .003), difference between groups, 15.0% (95% CI 5.4%-24.6%). Among black individuals, 96.2% and 63.2% in the home and clinic arms screened (P = .006). Among individuals with HIV, 89.5% and 51.9% in the home and clinic arms screened (P < .001). Self-collected swabs and clinician-collected swabs were comparable in adequacy for HPV genotyping (96.3% and 93.3%, respectively). People at highest risk for anal cancer may be more likely to screen if they are able to self-collect swabs at home rather than attend a clinic.