Abstract

Background

No standard treatment for anorectal fistula cancer, such as multidisciplinary therapy, has been established due to the rarity of the disease. Herein, we investigated patients with cancer associated with anorectal fistula who underwent surgery to clarify the clinicopathological characteristics and to propose future perspectives for treatment strategies.

Case presentation

Seven patients with cancer associated with anorectal fistula who underwent rectal amputation in our institute were analyzed with regard to clinical characteristics, pathological findings, surgical results, and prognosis. Four cases had Crohn's disease as an underlying cause. All seven cases were diagnosed as advanced stage. Preoperative [18F]-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography/computed tomography (FDG-PET/CT) showed abnormal FDG accumulation in six cases including four mucinous adenocarcinomas. Three cases that received preoperative hyperthermo-chemoradiotherapy achieved pathological R0 resection. Postoperative recurrence was observed in four cases including three with Crohn's disease and one resulting in death.

Conclusions

Anorectal fistula cancer is rare and difficult to be diagnosed at early stages. Mucinous adenocarcinoma associated with anorectal fistula tends to exhibit abnormal FDG accumulation by FDG-PET/CT unlike common colorectal mucinous adenocarcinoma. Preoperative hyperthermo-chemoradiotherapy may be effective in obtaining pathological complete resection.

Details

Title
Outcomes of surgical treatment in patients with anorectal fistula cancer
Author
Osone Katsuya 1   VIAFID ORCID Logo  ; Ogawa Hiroomi 1 ; Katayama Chika 1 ; Shibasaki Yuta 1 ; Suga Kunihiko 1 ; Komine Chika 1 ; Ozawa Naoya 1 ; Okada Takuhisa 1 ; Shiraishi Takuya 1 ; Katoh Ryuji 1 ; Sakai Makoto 1 ; Sano Akihiko 1 ; Yokobori Takehiko 2 ; Matsumura Nozomi 3 ; Sohda Makoto 1 ; Shirabe Ken 1 ; Saeki, Hiroshi 1 

1  Gunma University, Department of General Surgical Science, Graduate School of Medicine, Maebashi, Japan (GRID:grid.256642.1) (ISNI:0000 0000 9269 4097) 
2  Gunma University Initiative for Advanced Research (GIAR), Division of Integrated Oncology Research, Maebashi, Japan (GRID:grid.256642.1) (ISNI:0000 0000 9269 4097) 
3  Gunma University Graduate School of Medicine, Department of Human Pathology, Maebashi, Japan (GRID:grid.256642.1) (ISNI:0000 0000 9269 4097) 
Publication year
2021
Publication date
Jan 2021
Publisher
International Academic Publishing Co Ltd.
e-ISSN
21987793
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s40792-021-01118-6
ProQuest document ID
2480894970
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.