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. 2024 Mar 25;10(1):71.
doi: 10.1186/s40792-024-01873-2.

Squamous cell carcinoma of the anus successfully treated with multidisciplinary therapy for metachronous metastatic and local recurrences after DCF chemotherapy: a case report

Ryozan Naito  1 , Takuya Shiraishi  2 , Nobuhiro Hosoi  1 , Takayoshi Watanabe  1 , Ikuma Shioi  1 , Yuta Shibasaki  1 , Nobuhiro Nakazawa  1 , Katsuya Osone  1 , Takuhisa Okada  1 , Akihiko Sano  1 , Makoto Sakai  1 , Hiroomi Ogawa  1 , Makoto Sohda  1 , Ken Shirabe  1 , Hiroshi Saeki  1
Affiliations

Squamous cell carcinoma of the anus successfully treated with multidisciplinary therapy for metachronous metastatic and local recurrences after DCF chemotherapy: a case report

Ryozan Naito et al. Surg Case Rep. .

Abstract

Background: Docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy is reportedly an effective treatment strategy for squamous cell carcinoma of the anus (SCCA). However, studies regarding its use in Japanese patients remain scarce.

Case presentation: Here, we present the case of an 82-year-old woman with SCCA, cStage IIIB. Chemoradiotherapy was initiated after colostomy of the anorectal mass; however, para-aortic lymph node recurrence was observed 3 months after treatment completion. Five courses of DCF chemotherapy were subsequently administered, resulting in a complete response (CR). Two years and 1 month later, the aortic lymph node was enlarged again, and the patient achieved CR again after radiotherapy. Nine months later, local recurrence was detected in the anal canal, and laparoscopic perineal rectal amputation was performed. The patient remains progression-free 5 years and 10 months after the initial treatment and 1 year and 7 months after the final treatment.

Conclusions: Our findings suggest that complementary treatment after DCF chemotherapy may be efficacious in Japanese patients with SCCA and help achieve CR. Despite occasional local recurrences, this approach may help achieve long-term progression-free survival.

Keywords: 5-Fluorouracil; Cisplatin; Docetaxel; Squamous cell carcinoma of the anus.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Endoscopic, computed tomography (CT), and magnetic resonance imaging (MRI) findings at diagnosis. a Fully circumscribed, indistinct border, type IV tumor in the anal canal. b Fully circumscribed wall thickening at the anal canal with metastasis to the bilateral inguinal lymph nodes (arrow). c Fully circumscribed wall thickening at the anal canal involving the anal sphincter in T2-weighted image (arrow). d The same slice as in c in diffusion-weighted image
Fig. 2
Fig. 2
Axial computed tomography slice after chemoradiotherapy. Primary lesion and pelvic and inguinal lymph nodes achieved complete response
Fig. 3
Fig. 3
Pre- or post-DCF chemotherapy of the para-aortic lymph node status in an axial CT slice. a Para-aortic lymph node recurrence is observed (arrow). b After initiating DCF chemotherapy, para-aortic lymph node recurrence demonstrated CR. DCF docetaxel, cisplatin, and 5-fluorouracil
Fig. 4
Fig. 4
Para-aortic lymph node status pre- and post-radiation therapy assessed using axial CT imaging. a Para-aortic lymph node recurrence is observed again (arrow). b After intensity-modulated radiation therapy is initiated, para-aortic lymph node recurrence demonstrates CR. CR complete response, CT computed tomography
Fig. 5
Fig. 5
Endoscopic and CT findings at local recurrence. a Colonoscopy reveals extramural displacement in the anus. b CT image indicating local recurrence of a primary lesion of the anus (arrow). CT computed tomography
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