ArticleAnnals of surgical oncology2023
Fistula-Associated Anal Adenocarcinoma: A 20-Year Single-Center Experience.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 11 citations in OpenAlex.
- Anal canal neoplasms in the modern era: integrating HPV biology, LAST terminology, and evolving molecular classification.Virchows Archiv : an international journal of pathology · 2026Review
- Clinicopathology of adenocarcinoma originating from the anal gland with immunohistochemical expressions of GATA3 and TTF-1: a case report and literature review.Frontiers in oncology · 2026Article
- First case of hemorrhoidal carcinoma in a fistulotomy scar: successful per-anal endoscopic myectomy despite severe fibrosis.Endoscopy · 2025Article
- Nonfistulizing Perianal Crohn's Disease.Clinics in colon and rectal surgery · 2025Review
- "Budding"-an early MRI feature established in a case-control study of perianal fistula mucinous adenocarcinoma.Journal of gastrointestinal oncology · 2025Article
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFistula-associated anal adenocarcinoma (FAAC) is a rare consequence in patients with long-standing perianal fistulas. A paucity of data are available for this patient collective, making clinical characterization and management of this disease difficult.
objectiveThis study aimed to describe a single-center experience with FAAC patients, their clinical course, and histopathological and molecular pathological characterization.
methodsAll patients receiving surgery for an anal fistula in 1999-2019 at a tertiary university referral hospital were included in this retrospective analysis. Patients with FAAC were eligible for histopathological analysis, including immunohistochemistry and molecular profiling.
resultsThis study included 1004 patients receiving surgical treatment for an anal fistula, of whom 242 had an underlying inflammatory bowel disease (IBD). Ten patients were diagnosed with a fistula-associated anal carcinoma (1.0%), and six of these patients had an FAAC (0.6%). The mean overall survival of FAAC patients was 24 ± 3 months. FAAC immunohistochemistry revealed positive staining for CK20, CDX2 and MUC2, while stainings for CK5/6 and CK7 were negative. All FAAC specimens revealed microsatellite stability. Molecular profiling detected mutations in 35 genes, with the most frequent mutations being TP53, NOTCH1, NOTCH3, ATM, PIK3R1 and SMAD4.
conclusionFAAC is rare but associated with poor clinical outcome. Tissue acquisition is crucial for early diagnosis and therapy and should be performed in long-standing, non-healing, IBD-associated fistulas in particular. The immunophenotype of FAAC seems more similar to the rectal-type mucosa than the anal glands.
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