Rogers Jane E, Sirisaengtaksin Amanda, Leung Michael, Morris Van K, Xiao Lianchun, Huey Ryan, Wolff Robert, Eng Cathy, Vauthey Jean Nicolas, Tzeng Ching-Wei D, Johnson Benny
Pharmacy Clinical Programs, U.T. M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Department of Gastrointestinal Medical Oncology, U.T. M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Cancers (Basel). 2023 Jul 31;15(15):3890. doi: 10.3390/cancers15153890.
Squamous cell carcinoma of the anal canal (SCCA) is rare. Most cases are diagnosed in a localized setting. Metastatic SCCA is rare, and investigation has been limited in the past for these patients. We believe that hepatic-only metastatic disease could have a unique treatment landscape compared to diseases with diffuse metastatic involvement. Here, we describe cases at our institution.
We reviewed eight SCCA cases with hepatic-only metastatic disease (diagnosed February 2018-January 2022). The objectives were to determine the overall survival and disease-free survival with this approach.
The median age was 62 years old (yo). Patients had an ECOG of 0-1. All patients received definitive chemoradiation to their primary anal tumor. A median of three months of neoadjuvant systemic therapy was provided. All patients had a response on their first scan after systemic therapy. Sixty-two percent received carboplatin + paclitaxel. A complete pathologic response was seen in 62% of patients. At their last follow-up, all patients were alive. Three patients had recurrent disease. The estimated 1-year disease-free survival probability was 56.2%.
Our report shows the feasibility of a curative-intent approach for patients with hepatic-only metastatic SCCA following the neoadjuvant application of carboplatin + paclitaxel. This approach appears promising in these select patients and warrants further investigation.
肛管鳞状细胞癌（SCCA）较为罕见。大多数病例在局部阶段被诊断出来。转移性SCCA很少见，过去对这些患者的研究有限。我们认为，与有弥漫性转移累及的疾病相比，仅肝转移的疾病可能有独特的治疗前景。在此，我们描述我们机构的病例。
我们回顾了8例仅肝转移的SCCA病例（2018年2月至2022年1月确诊）。目的是确定这种治疗方法的总生存期和无病生存期。
中位年龄为62岁。患者的东部肿瘤协作组（ECOG）评分为0 - 1。所有患者均接受了针对原发性肛管肿瘤的根治性放化疗。提供了中位为期三个月的新辅助全身治疗。所有患者在全身治疗后的首次扫描中均有反应。62%的患者接受了卡铂 + 紫杉醇治疗。62%的患者出现了完全病理缓解。在最后一次随访时，所有患者均存活。3例患者出现疾病复发。估计1年无病生存概率为56.2%。
我们的报告显示了在新辅助应用卡铂 + 紫杉醇后，对仅肝转移的SCCA患者采用根治性治疗方法的可行性。这种方法在这些特定患者中似乎很有前景，值得进一步研究。
