REVIEW ARTICLE
Brazilian Society of Surgical Oncology: Guidelines for the management of anal canal cancer
Marcus Valadão MD, PhD,
Rachel P. Riechelmann MD, PhD,
José Antonio Cunha e Silva MD, MSc,
Jorge Mali Jr, MD, PhD,
Bruno Azevedo MD,
Samuel Aguiar MD, PhD,
Rodrigo Araújo MD, PhD,
Mario Feitoza MD,
Eid Coelho MD,
Arthur Accioly Rosa MD,
Naomi Jay PhD,
Alexcia Camila Braun PhD,
Rodrigo Pinheiro MD, PhD,
Héber Salvador MD, PhD,
Corresponding Author
Marcus Valadão MD, PhD
Department of Abdomino-Pelvic Surgery, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
Correspondence Marcus Valadão, MD, PhD, Department of Abdomino-Pelvic Surgery, Instituto Nacional de Cancer, Rio de Janeiro, Brazil. Praça Cruz Vermelha, 23, Centro, Rio de Janeiro, CEP: 20.230-130, Brazil.
Email: [email protected]
Search for more papers by this authorRachel P. Riechelmann MD, PhD
Department of Clinical Oncology, AC Camargo Cancer, CenterSão Paulo, Brazil
Search for more papers by this authorJosé Antonio Cunha e Silva MD, MSc
Department of Surgery, Hospital Universitário Antônio Pedro, Niterói, Brazil
Search for more papers by this authorJorge Mali Jr, MD, PhD
Department of Surgery, Hospital do Câncer de Londrina, Londrina, Brazil
Search for more papers by this authorBruno Azevedo MD
Department of Surgical Oncology, Grupo Oncoclínicas, Curitiba, Brazil
Search for more papers by this authorSamuel Aguiar MD, PhD
Department of Surgical Oncology, AC Camargo Cancer, CenterSão Paulo, Brazil
Search for more papers by this authorRodrigo Araújo MD, PhD
Department of Abdomino-Pelvic Surgery, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
Search for more papers by this authorMario Feitoza MD
Brazilian Society of Surgical Oncology, Rio de Janeiro, Brazil
Search for more papers by this authorEid Coelho MD
Department of Surgery, Hospital São Marcos, Teresina, Brazil
Search for more papers by this authorArthur Accioly Rosa MD
Department of Radiation Oncology, Oncoclinicas Salvador-Hospital Santa Izabel, Salvador, Brazil
Search for more papers by this authorNaomi Jay PhD
San Francisco School of Medicine, University of California, San Francisco, California, USA
Search for more papers by this authorAlexcia Camila Braun PhD
Brazilian Society of Surgical Oncology, Rio de Janeiro, Brazil
Search for more papers by this authorRodrigo Pinheiro MD, PhD
Department of Surgical Oncology, Hospital de Base do Distrito Federal, Brasilia, Brazil
Search for more papers by this authorHéber Salvador MD, PhD
Department of Surgical Oncology, AC Camargo Cancer, CenterSão Paulo, Brazil
Search for more papers by this authorMarcus Valadão MD, PhD,
Rachel P. Riechelmann MD, PhD,
José Antonio Cunha e Silva MD, MSc,
Jorge Mali Jr, MD, PhD,
Bruno Azevedo MD,
Samuel Aguiar MD, PhD,
Rodrigo Araújo MD, PhD,
Mario Feitoza MD,
Eid Coelho MD,
Arthur Accioly Rosa MD,
Naomi Jay PhD,
Alexcia Camila Braun PhD,
Rodrigo Pinheiro MD, PhD,
Héber Salvador MD, PhD,
Corresponding Author
Marcus Valadão MD, PhD
Department of Abdomino-Pelvic Surgery, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
Correspondence Marcus Valadão, MD, PhD, Department of Abdomino-Pelvic Surgery, Instituto Nacional de Cancer, Rio de Janeiro, Brazil. Praça Cruz Vermelha, 23, Centro, Rio de Janeiro, CEP: 20.230-130, Brazil.
Email: [email protected]
Search for more papers by this authorRachel P. Riechelmann MD, PhD
Department of Clinical Oncology, AC Camargo Cancer, CenterSão Paulo, Brazil
Search for more papers by this authorJosé Antonio Cunha e Silva MD, MSc
Department of Surgery, Hospital Universitário Antônio Pedro, Niterói, Brazil
Search for more papers by this authorJorge Mali Jr, MD, PhD
Department of Surgery, Hospital do Câncer de Londrina, Londrina, Brazil
Search for more papers by this authorBruno Azevedo MD
Department of Surgical Oncology, Grupo Oncoclínicas, Curitiba, Brazil
Search for more papers by this authorSamuel Aguiar MD, PhD
Department of Surgical Oncology, AC Camargo Cancer, CenterSão Paulo, Brazil
Search for more papers by this authorRodrigo Araújo MD, PhD
Department of Abdomino-Pelvic Surgery, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
Search for more papers by this authorMario Feitoza MD
Brazilian Society of Surgical Oncology, Rio de Janeiro, Brazil
Search for more papers by this authorEid Coelho MD
Department of Surgery, Hospital São Marcos, Teresina, Brazil
Search for more papers by this authorArthur Accioly Rosa MD
Department of Radiation Oncology, Oncoclinicas Salvador-Hospital Santa Izabel, Salvador, Brazil
Search for more papers by this authorNaomi Jay PhD
San Francisco School of Medicine, University of California, San Francisco, California, USA
Search for more papers by this authorAlexcia Camila Braun PhD
Brazilian Society of Surgical Oncology, Rio de Janeiro, Brazil
Search for more papers by this authorRodrigo Pinheiro MD, PhD
Department of Surgical Oncology, Hospital de Base do Distrito Federal, Brasilia, Brazil
Search for more papers by this authorHéber Salvador MD, PhD
Department of Surgical Oncology, AC Camargo Cancer, CenterSão Paulo, Brazil
Search for more papers by this authorAbstract
Background
Anal canal squamous cell carcinoma (SCC) is a relatively uncommon neoplasia, and it is mostly a local-regional cancer, of low metastatic potential (only 15%), resulting in cure in most cases treated with definitive chemoradiation. On the other hand, its incidence has been steadily increasing over the last decades, which makes it an important public health problem. In an effort to provide surgeons and oncologists who treat patients with anal cancer with the most updated information based on the best scientific evidence, the Brazilian Society of Surgical Oncology (SBCO) has produced the present guideline for the management of anal canal SCC, focused on the main topics related to daily clinical practice.
Objectives
The SBCO developed the present guidelines to provide recommendations on the main topics related to the management of anal canal squamous cell carcinoma (SCC) based on current scientific evidence.
Methods
Between October 2022 and January 2023, 14 experts met to develop the guidelines for the management of anal canal cancer. A total of 30 relevant topics were distributed among the participants. The methodological quality of a final list with 121 sources was evaluated, all the evidence was examined and revised, and the management guidelines were formulated by the 14-expert committee. To reach a final consensus, all the topics were reviewed in a meeting that was attended by all the experts.
Results
The proposed guidelines contained 30 topics considered to be highly relevant in the management of anal canal cancer, covering subjects related to screening recommendations, preventive measures, tests required for diagnosing and staging, treatment strategies, response assessment after chemoradiotherapy, surgical technique-related aspects, and follow-up recommendations. In addition, screening and response assessment algorithms, and a checklist were proposed to summarize the important information and offer an updated tool to assist surgeons and oncologists who treat anal canal cancer and in providing the best care to their patients.
Conclusion
These guidelines summarize recommendations based on the most current scientific evidence on relevant aspects of anal canal cancer management and are a practical guide to help surgeons and oncologists who treat anal canal cancer make the best therapeutic decisions.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
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