Anal Cancer

Questions discussed in this category

What are your top takeaways in GI Cancers from ESMO 2024?

Would you offer inguinal nodal RT to a patient with anal SCC (pT1N1a, + inguinal node) following APR in the setting of prior prostate + pelvic nodal radiation?

More specifically, the patient had a single, positive, 3 cm inguinal LN (no ECE, negative margins) removed at the time of APR. If offering RT, would y...

2 Answers available

When treating a bulky squamous cell carcinoma of the anal canal, do you try to limit the dose to the external anal sphincter to any particular number to reduce the risk of chronic fecal incontinence?

Especially if using an escalated dose such as 58 Gy in 29 fractions for a T3-T4 primary

1 Answer available

Are you using vaginal dilators during treatment of rectal cancer to spare anterior vaginal wall, or are you reserving this for anal cancers?

1 Answer available

For anal radiation dermatitis, does anyone have experience with 3M Cavilon protectant?

1 Answer available

What is the best treatment regimen for a fungating SCCa of the scrotum arising from untreated genital warts invading the groin and base of the penis with bilateral inguinal nodes?

Surgery would be very extensive and would not be likely to clear the disease. Do you divert these patients if treated with CRT?

1 Answer available

How would you approach an MSI-H HPV+ T2 N1 squamous cell carcinoma of the anus?

Would you offer as first line treatment mitomycin/5FU with radiation or single agent immunotherapy?

2 Answers available

How would you treat a synchronous low rectal adenocarcinoma and anal squamous cell carcinoma with involved pelvic and inguinal nodes?

What systemic therapy is most appropriate, how would you sequence, and what RT dose fractionation would you use?

6 Answers available

In patients with perianal squamous cell carcinoma extending to the vulva, would you cover the entire vulva or would generous margins on the gross disease suffice?

4 Answers available

How would you treat ESRD patients on HD with locoregional squamous cell carcinoma of the anus?

Would you use a different chemotherapy regimen than mitomycin/5FU?

1 Answer available

What is your recommended management for a pT1N0 perianal moderately differentiated SCC s/p wide local excision with close 1 mm deep margin?

Not a candidate for re-excision given proximity to the anal sphincter. Consider +PNI, -LVI.

1 Answer available

How would you treat a synchronous anal canal squamous cell carcinoma and localized high risk prostate adenocarcinoma?

2 Answers available

How do you manage grade 3 enterocolitis from 5FU mitomycin and pelvic radiotherapy?

C diff infection ruled out and CT abdomen pelvis shows diffuse enterocolitis extending far beyond the bowel-sparing IMRT radiotherapy field.

2 Answers available

Would you consider upfront immunotherapy in a patient with MSI strongly positive locally advanced adenocarcinoma of the anus versus standard of care?

1 Answer available

Would you treat rectal squamous cell carcinoma the same as rectal adenocarcinoma, stage for stage?

Any adjustments in terms of elective nodal coverage?

4 Answers available

What dose do you use for T2 anal squamous cell carcinomas measuring greater than 3cm?

For T2N0 anal squamous cell carcinoma, RTOG 0529 used 50.4/42Gy in 28 fractions. However, for nodal disease >3cm, 54Gy in 30 fractions is used (and...

2 Answers available

How would you manage recurrent anal SCC after chemoradiation, with positive margins after resection?

1 Answer available

Would you consider using adjuvant chemotherapy for a patient with anal squamous cell carcinoma with a positive surgical margin after APR done for persistent/progressive disease after chemoradiotherapy?

1 Answer available

How would you manage a localized small cell carcinoma of the anal canal without nodal or distant disease?

Ki-67 > 95%, PET-CT negative for any additional disease.

1 Answer available

What neoadjuvant chemotherapy would you consider for squamous cell carcinoma arising from a ruptured tailgut cyst?

Would you extrapolate treatment from the paradigm of anal SCC?

1 Answer available

How would you manage a male with a prior history of localized prostate cancer s/p radiation to prostate only (two years ago), who now presents with a T1N0 squamous cell carcinoma of the anus?

Would your management change if the prostate and lymph nodes were treated with radiation two years ago?

2 Answers available

How would manage a patient with stage III anal cancer and history of Child–Pugh B liver cirrhosis with platelets count of less than 100,000?

exam is + for ascites

1 Answer available

What radiation sensitizer do you recommend for early stage poorly differentiated squamous cell carcinoma of the anus, in a patient with stage IV chronic kidney disease?

For a patient not on dialysis? Outside of single agent 5FU, all other standard chemotherapeutic options would be contraindicated for nephrotoxicity.&n...

1 Answer available

Would you recommend chemoradiation to the pelvis for a patient with squamous cell carcinoma of the anus metastatic to the liver who has had a complete response to chemotherapy in the pelvis and a liver resection?

2 Answers available

How would you approach a patient with Li Fraumeni syndrome and a mucinous anal adenocarcinoma with inguinal node metastases?

Would presence of TP53 mutation weigh in on the offer of radiation? Would there be any change expected on the chemo regimen?

1 Answer available

In what situations, if any, would you treat locally advanced (non metastatic) anal cancer with induction chemotherapy followed by chemoRT rather than chemo/RT by itself?

2 Answers available

How would you manage a patient with Lynch syndrome who is s/p surgery and pelvic RT 20+ years ago for endometrial carcinoma with a new T3N0M0 squamous cell carcinoma of the anus?

The patient refuses surgery.

2 Answers available

Do you recommend neoadjuvant radiation or chemoradiation for patients with T1-2 N0 adenocarcinoma of the anal canal prior to APR?

2 Answers available

What systemic therapy option do you use for metastatic, anal squamous cancer with progression following FOLFOX and subsequent nivolumab?

1 Answer available

Should definitive concurrent chemoRT be offered to patients with anal canal SCCa with common iliac nodal involvement (by definition M1 disease) without evidence for other distant disease?

2 Answers available

How would you mange true anal margin squamous cell carcinoma (with no involvement of anal canal) if wide local excision cannot be done and chemoradiation therapy is being used instead?

Anal cancer guidelines mostly refer to anal canal tumors with less information about tumors of skin in perianal area (ie true anal margin). Would IMR...

2 Answers available

What dose do you typically prescribe to the primary tumor for definitive treatment of squamous cell carcinoma of the anal canal (given concurrently with chemotherapy)?

Do you have different preferences based on T-stage?

6 Answers available

Would you ever recommend resection only (no chemorads) for a T1N0 anal canal cancer?

1 Answer available

Which chemotherapy regimen do you prefer for concurrent treatment with radiation therapy for anal squamous cell carcinoma?

5FU/mitomycin C or 5FU/cisplatin? Is there any benefit of cisplatin in terms of skin toxicity?

2 Answers available

Among patients with anal SCC, is it reasonable to replace 5-FU with capecitabine when delivering definitive chemoradiotherapy with concurrent mitomycin C?

1 Answer available

How do you choose a dose of 5-FU during chemo-radiation for a patient with rectal cancer who is dialysis dependent?

1 Answer available

Would you consider BID treatment for a patient with a pelvic SCC (e.g. cervix or anal) if a significant amount of treatment days have been missed?

For example, a patient with cervical or anal SCC who has missed many treatments due to side effects, low blood counts, hospitalizations, or non-compli...

1 Answer available

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

Is inguinal coverage always required?

3 Answers available

Are there any special considerations when treating a patient with anal cancer who has poorly managed HIV/AIDS?

2 Answers available

Would you treat the inguinal nodes in a patient who had an adenocarcinoma excised from the anal canal?

In a lesion <2.5 cm from anal verge arising in a tubulovillous adenoma, does the data from Taylor, et. al. Red Journal 2001 apply?

2 Answers available

What is the evidence that there is a benefit to giving doses higher than 3060 cGy-3600 cGy in the elective treatment of uninvolved lymph nodes in the treatment of SCC of anal canal with chemoradiation?

3 Answers available

How do you manage squamous cell carcinoma in situ of the anus?

While the Nigro/Wayne state regimen consisting of Mito C & 5FU is well stablished for squamous cell carcinoma of the anus/perianal tissue, a...

1 Answer available

Papers discussed in this category

Int. J. Radiat. Oncol. Biol. Phys., 2008-02-01

Involved-field, low-dose chemoradiotherapy for early-stage anal carcinoma.

Cancer, 1983-05-15

Combined preoperative radiation and chemotherapy for squamous cell carcinoma of the anal canal.

Cancer, 2010-02-15

Long-term quality of life after radiotherapy for the treatment of anal cancer.

International journal of radiation oncology, biology, physics, 2013-05-01

RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal.

Dis. Colon Rectum, 2014-04-01

Long-term effects of chemoradiotherapy for anal cancer in patients with HIV infection: oncological outcomes, immunological status, and the clinical course of the HIV disease.

Clin Oncol (R Coll Radiol), 2017-04-01

Are there HIV-specific Differences for Anal Cancer Patients Treated with Standard Chemoradiotherapy in the Era of Combined Antiretroviral Therapy?

Cancer medicine, 2016-12

Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-12-10

Long-term update of US GI intergroup RTOG 98-11 phase III trial for anal carcinoma: survival, relapse, and colostomy failure with concurrent chemoradiation involving fluorouracil/mitomycin versus fluorouracil/cisplatin.

Lancet Oncol., 2013-05-01

Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 × 2 factorial trial.

Radiat Oncol, 2014 May 29

Chemoradiation with capecitabine and mitomycin-C for stage I-III anal squamous cell carcinoma.

Br. J. Cancer, 2014 Aug 28

Chemoradiotherapy with capecitabine for locally advanced anal carcinoma: an alternative treatment option.

J Gastrointest Cancer,

Phase II Study of Capecitabine in Substitution of 5-FU in the Chemoradiotherapy Regimen for Patients with Localized Squamous Cell Carcinoma of the Anal Canal.

International journal of radiation oncology, biology, physics, 2009-11-01

Intensity-modulated radiation therapy for the treatment of squamous cell anal cancer with para-aortic nodal involvement.

Neuroendocrinology, 2019 Aug 21

Chemotherapy in resected neuroendocrine carcinomas of the digestive tract: a national study from the French Group of Endocrine Tumours (GTE).

Ann. Surg., 2019 Aug 30

Adjuvant Chemotherapy Versus Observation Following Resection for Patients With Nonmetastatic Poorly Differentiated Colorectal Neuroendocrine Carcinomas.

Cancer, 2018-02-15

Comparative study of lung and extrapulmonary poorly differentiated neuroendocrine carcinomas: A SEER database analysis of 162,983 cases.

Clin Colorectal Cancer, 2020 Dec 17

Neuroendocrine Carcinoma of the Anus and Rectum: Patient Characteristics and Treatment Options.

J. Clin. Oncol., 2020 Jun 12

International Rare Cancers Initiative Multicenter Randomized Phase II Trial of Cisplatin and Fluorouracil Versus Carboplatin and Paclitaxel in Advanced Anal Cancer: InterAAct.

Lancet Gastroenterol Hepatol, 2022 Feb 01

Pembrolizumab for previously treated advanced anal squamous cell carcinoma: results from the non-randomised, multicohort, multicentre, phase 2 KEYNOTE-158 study.

Oncologist, 2022 Feb 3

Definitive Intensity-Modulated Chemoradiation for Anal Squamous Cell Carcinoma: Outcomes and Toxicity of 428 Patients Treated at a Single Institution.

N Engl J Med, 2022 Jun 05

PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal Cancer.

Front Oncol, 2020

Multi-Institutional Analysis of Synchronous Prostate and Rectosigmoid Cancers.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-07-10

Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients With Low-Risk Prostate Cancer.

Int J Radiat Oncol Biol Phys, 2021 Aug 14

Long-Term Outcomes of NRG Oncology/RTOG 0529: A Phase 2 Evaluation of Dose-Painted Intensity Modulated Radiation Therapy in Combination With 5-Fluorouracil and Mitomycin-C for the Reduction of Acute Morbidity in Anal Canal Cancer.

Frontiers in oncology, 2023 Jun 29

Risk-adjusted chemoradiation according to human papilloma viral status for anal cancer: a pilot study.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2021 Dec 20

Rectal cancer with synchronous inguinal lymph node metastasis without distant metastasis. A call for further oncological evaluation.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2010 Oct

Inguinal lymph node metastases are recognized with high frequency in rectal adenocarcinoma invading the dentate line. The histological features at the invasive front may predict inguinal lymph node metastasis.

Cancer medicine, 2018-12

Squamous cell carcinoma of the rectum: Practice trends and patient survival.

Oncology (Williston Park, N.Y.), 2018-01-15

Woman With Rare Cause of Rectal Bleeding.

Frontiers in oncology, 2023 Jun 08

Case report of unusual synchronous anal and rectal squamous cell carcinoma: clinical and therapeutic lesson.

Cancer, 2001 Jul 01

Management of inguinal lymph node metastases in patients with carcinoma of the anal canal: experience in a series of 270 patients treated in Lyon and review of the literature.

Cardiovascular and interventional radiology, 2022 Feb 04