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Hervé L, Kim S, Boustani J, Klajer E, Pernot M, Nguyen T, Lakkis Z, Borg C, Vienot A. Modified DCF (Docetaxel, Cisplatin and 5-fluorouracil) chemotherapy is effective for the treatment of advanced rectal squamous cell carcinoma. Front Oncol 2022; 12:974108. [DOI: 10.3389/fonc.2022.974108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022] Open
Abstract
BackgroundAdvanced rectal squamous cell carcinoma (rSCC) is a very rare and aggressive entity, and the best initial management is crucial for long survival as well as organ preservation and quality of life. Whereas local diseases are treated with chemo-radiotherapy and salvage surgery, data are scarce on how to treat more advanced diseases, and the role of induction chemotherapy is unknown.MethodsWe retrospectively analyzed all consecutive patients with advanced rSCC and treated with modified DCF (docetaxel, cisplatin, 5-fluorouracil; mDCF) regimen, from January 2014 and December 2021 in two French centers. Exploratory endpoints were efficacy (overall survival, recurrence-free survival, response rate, organ preservation rate) and safety.ResultsNine patients with locally advanced or metastatic diseases received a mDCF regimen and were included for analysis. The median age was 62.0 years, 7 patients (77.8%) were women, and all eight available tumors were positive for HPV, mostly (85.7%) to genotype 16. With a median follow-up of 33.1 months, 77.8% of patients were still alive and disease-free, and the median overall survival was not reached at six years. The objective response rate was 87.5% after mDCF, and the complete response rate was 25.0% after mDCF and was increased to 75.0% after chemoradiotherapy. Only one patient underwent surgery on the primary tumor, with a complete pathological response. The median mDCF cycle was eight over eight scheduled, and all patients received the complete dose of radiotherapy without interruptions.ConclusionsInduction mDCF chemotherapy followed by chemoradiotherapy is safe and highly effective in patients with advanced rSCC, and should be considered as an option in metastatic stage or locally advanced disease with an organ-preservation strategy.
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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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Abrogation of EMILIN1-β1 integrin interaction promotes experimental colitis and colon carcinogenesis. Matrix Biol 2019; 83:97-115. [PMID: 31479698 DOI: 10.1016/j.matbio.2019.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/30/2019] [Accepted: 08/30/2019] [Indexed: 12/14/2022]
Abstract
Colon cancer is one of the first tumor types where a functional link between inflammation and tumor onset has been described; however, the microenvironmental cues affecting colon cancer progression are poorly understood. Here we demonstrate that the expression of the ECM molecule EMILIN-1 halts the development of AOM-DSS induced tumors. In fact, upon AOM-DSS treatment the Emilin1-/- (E1-/-) mice were characterized by a higher tumor incidence, bigger adenomas and less survival. Similar results were obtained with the E933A EMILIN-1 (E1-E933A) transgenic mouse model, expressing a mutant EMILIN-1 unable to interact with α4/α9β1 integrins. Interestingly, upon chronic treatment with DSS, E1-/- and E1-E933A mice were characterized by the presence of increased inflammatory infiltrates, higher colitis scores and more severe mucosal injury respect to the wild type (E1+/+) mice. Since alterations of the intestinal lymphatic network are a well-established feature of human inflammatory bowel disease and EMILIN-1 is a key structural element in the maintenance of the integrity of lymphatic vessels, we assessed the lymphatic vasculature in this context. The analyses revealed that both E1-/- and E1-E933A mice displayed a higher density of LYVE-1 positive vessels; however, their functionality was severely compromised after colitis induction. Taken together, these results suggest that the loss of EMILIN-1 expression may cause the reduction of the inflammatory resolution during colon cancer progression due to a decreased lymph flow and impaired inflammatory cell drainage.
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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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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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Hassan U, Mozayani B, Wong NACS. Primary combined neuroendocrine carcinoma (small-cell type) and squamous cell carcinoma of the colon. Histopathology 2015. [PMID: 26212098 DOI: 10.1111/his.12786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Usman Hassan
- Department of Histopathology, Bristol Royal Infirmary, Bristol, UK
| | - Behrang Mozayani
- Department of Cellular Pathology, Southmead Hospital, Bristol, UK
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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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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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Lord JD, Upton MP, Hwang JH. Confocal endomicroscopic evaluation of colorectal squamous metaplasia and dysplasia in ulcerative colitis. Gastrointest Endosc 2011; 73:1064-6. [PMID: 21067733 PMCID: PMC4360953 DOI: 10.1016/j.gie.2010.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 09/01/2010] [Indexed: 02/08/2023]
Affiliation(s)
- James D. Lord
- Translational Research Program, Benaroya Research Institute, 1201 Ninth Ave., Mailstop IN-RC, Seattle, WA 98101-2795, U.S.A., Phone: 206-287-1088, Fax: 206-342-6580
| | - MP Upton
- Rodger C. Haggitt Gastrointestinal and Hepatic Pathology Service, UWMC. University of Washington 1959 NE Pacific Street, Seattle, WA, 98195, Phone: (206) 598-0006 Fax: (206) 598-4928
| | - JH Hwang
- Gastroenterology Section, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA, 98104, Phone: (206) 744-7050, Fax: (206) 744-8698
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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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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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van den Broek FJC, Reitsma JB, Curvers WL, Fockens P, Dekker E. Systematic review of narrow-band imaging for the detection and differentiation of neoplastic and nonneoplastic lesions in the colon (with videos). Gastrointest Endosc 2009; 69:124-35. [PMID: 19111693 DOI: 10.1016/j.gie.2008.09.040] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Accepted: 09/20/2008] [Indexed: 02/06/2023]
Affiliation(s)
- Frank J C van den Broek
- Department of Gastroenterology and Hepatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
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