Are there situations in which elective nodal volumes may be reduced for T1/T2N0 anal SCC?  

I have treated several elderly patients with small tumors using this low dose, limited field regimen. All did well. Involved-Field, Low-Dose Chemoradiotherapy for Early-Stage Anal Carcinoma Paul Hatfield, M.D., Ph.D., F.R.C.R., Rachel Cooper, M.D., M.Sc., F.R.C.R., David Sebag-Montefiore, M.D.,...

There is another paper from France where they looked at the subsequent risk of inguinal nodes in untreated patients.  I wish I could remember the reference, but I recall a 14% risk of failure in the nodes.   T1 tumors are not all the same.  A well differentiated tumor at the anal ve...

I think treatment volume reduction for early anal cancer is worthy of a prospective study.  However, there are several caveats.  It would be important to have careful imaging to make sure one really is dealing with cN0 disease.  I would recommmend FDG PET and careful review of imaging...