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Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature.

Publication ,  Journal Article
Song, EJ; Jacobs, CD; Palta, M; Willett, CG; Wu, Y; Czito, BG
Published in: J Gastrointest Oncol
April 2020

BACKGROUND: Colorectal cancer is the third most common cancer in the United States and associated with significant morbidity and mortality. Within colorectal cancer histologies, squamous cell carcinomas (SCC) are rare compared to adenocarcinomas, with only about 200 cases reported to date. Because rectal SCC is rarely encountered, there is a lack of literature and clinical consensus surrounding its optimal treatment approach. Staging and management of SCC can be partly analogous to both rectal adenocarcinoma and anal canal SCC, which leads to a dilemma in how to best approach these patients. As large randomized prospective trials are unrealistic in the setting of this rare malignancy, this study evaluates an institutional experience and reviews the existing literature to help guide future management approaches. METHODS: This retrospective study compared various treatment regimens for rectal SCC patients treated at Duke University Medical Center from January 1, 1980 through December 31, 2016. Patients ≥18 years old with histologically confirmed, nonmetastatic rectal SCC were included. Due to small sample size, all statistical analyses were descriptive. For our systematic review, a comprehensive search of PubMed from 1933 to March 2018 was performed, with selected articles referenced to ensure all relevant publications were included. A qualitative analysis was performed to examine patient diagnoses, treatments, and disease- and treatment-related outcomes. RESULTS: Eight patients were included. Three patients underwent initial, curative attempt surgery and two of these patients required colostomy. With follow-up ranging from 7.1 to 31.5 months, one patient was alive with no evidence of disease while two developed local/regional recurrences. Five patients received definitive chemoradiation. Of these, three patients developed local/regional and/or metastatic recurrence. Two patients achieved complete response on imaging and currently remain disease-free (follow-up of 31.5 and 33.6 months). CONCLUSIONS: Although the review of our institutional experience is limited by small numbers, our analysis suggests that definitive chemoradiation therapy is the preferred treatment approach to rectal SCC based on improved disease-related outcomes, sphincter preservation and morbidity profiles. This conclusion is supported by a systematic literature review.

Duke Scholars

Published In

J Gastrointest Oncol

DOI

ISSN

2078-6891

Publication Date

April 2020

Volume

11

Issue

2

Start / End Page

242 / 249

Location

China

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Song, E. J., Jacobs, C. D., Palta, M., Willett, C. G., Wu, Y., & Czito, B. G. (2020). Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature. J Gastrointest Oncol, 11(2), 242–249. https://doi.org/10.21037/jgo.2018.11.02
Song, Erin J., Corbin D. Jacobs, Manisha Palta, Christopher G. Willett, Yuan Wu, and Brian G. Czito. “Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature.J Gastrointest Oncol 11, no. 2 (April 2020): 242–49. https://doi.org/10.21037/jgo.2018.11.02.
Song EJ, Jacobs CD, Palta M, Willett CG, Wu Y, Czito BG. Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature. J Gastrointest Oncol. 2020 Apr;11(2):242–9.
Song, Erin J., et al. “Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature.J Gastrointest Oncol, vol. 11, no. 2, Apr. 2020, pp. 242–49. Pubmed, doi:10.21037/jgo.2018.11.02.
Song EJ, Jacobs CD, Palta M, Willett CG, Wu Y, Czito BG. Evaluating treatment protocols for rectal squamous cell carcinomas: the Duke experience and literature. J Gastrointest Oncol. 2020 Apr;11(2):242–249.

Published In

J Gastrointest Oncol

DOI

ISSN

2078-6891

Publication Date

April 2020

Volume

11

Issue

2

Start / End Page

242 / 249

Location

China

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences