{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T07:07:41Z","timestamp":1768460861910,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,10,9]],"date-time":"2015-10-09T00:00:00Z","timestamp":1444348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Adenocarcinomas associated with anal fistula are rare and often present at an advanced stage. They are often mistaken for commonly occurring benign diseases, leading to delayed diagnosis. Previous reports have predicted inferior oncological outcomes for these cases compared with sporadic rectal cancers. We are presenting our series of patients with colorectal adenocarcinoma associated with anal fistula who were treated with multimodality therapy at a tertiary cancer centre in India.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a retrospective review of a prospectively maintained database of patients treated at our centre between 1 July 2013 and 31 March 2015. Of the 15 patients included in the study, 11 had prior intervention in the form of seton placement or fistulotomy. Fourteen patients had circumferential resection margin (<jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content>) involvement at initial workup and hence were given neoadjuvant chemoradiotherapy (<jats:styled-content style=\"fixed-case\">NACRT<\/jats:styled-content>). None of the patients had distant metastasis and only 15% had regional nodal involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 13 patients included in the final analysis underwent abdominoperineal excision (<jats:styled-content style=\"fixed-case\">APE<\/jats:styled-content>). Ten patients (73%) underwent extralevator <jats:styled-content style=\"fixed-case\">APE<\/jats:styled-content>. Plastic reconstruction in the form of a V\u2013Y advancement flap for perineal closure was required in six patients (46%). On histopathological examination, a mucinous component was found to be present in 11 patients (73%). The quality of total mesorectal excision was complete in 92% patients. The <jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content> was free in 92% of patients. Median overall survival and disease\u2010free survival were not reached.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Colorectal adenocarcinomas associated with fistula are locally aggressive malignancies with a low incidence of lymph node involvement and distant metastasis. <jats:styled-content style=\"fixed-case\">NACRT<\/jats:styled-content>, wider resection in the form of extralevator <jats:styled-content style=\"fixed-case\">APE<\/jats:styled-content>, and liberal use of plastic reconstruction may result in favourable outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13100","type":"journal-article","created":{"date-parts":[[2015,8,24]],"date-time":"2015-08-24T09:20:56Z","timestamp":1440408056000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Multidisciplinary management of colorectal adenocarcinoma associated with anal fistula: an Indian series"],"prefix":"10.1111","volume":"17","author":[{"given":"V. D.","family":"Pai","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Tata Memorial Centre Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Jatal","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Tata Memorial Centre Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Engineer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Centre Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Ostwal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. P.","family":"Saklani","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Tata Memorial Centre Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02053944"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02554358"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-007-3651-0"},{"key":"e_1_2_10_5_1","first-page":"65","article-title":"The relation of fistula\u2010in\u2010ano to cancer of the anal canal","volume":"35","author":"Rosser C","year":"1934","journal-title":"Trans Am Proc Soc"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800710904"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02604325"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-006-0289-7"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9294-4"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-739X(06)70847-8"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-9026-1"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-006-0251-8"},{"key":"e_1_2_10_13_1","first-page":"276","article-title":"Implantation metastasis from adenocarcinoma of the sigmoid colon into a perianal fistula: a case report","volume":"27","author":"Gomes RM","year":"2014","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_10_14_1","first-page":"720","article-title":"Perianal adenocarcinoma associated with anal fistula: a report of 11 cases in a single institution focusing on treatment and literature review","volume":"60","author":"Hongo K","year":"2013","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2391041043"},{"key":"e_1_2_10_16_1","first-page":"220","article-title":"Successful sphincter\u2010sparing local excision for mucinous adenocarcinoma associated with chronic fistula in ano using preoperative MRI evaluation","volume":"93","author":"Yamaguchi T","year":"2008","journal-title":"Int Surg"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyi181"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1985.01390290106019"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(85)90081-9"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3862\/jcoloproctology.63.346"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3862\/jcoloproctology.58.415"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13100","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.13100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T19:11:48Z","timestamp":1696360308000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.13100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,9]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1111\/codi.13100"],"URL":"https:\/\/doi.org\/10.1111\/codi.13100","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,9]]},"assertion":[{"value":"2015-05-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-10-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}