Do you treat inguinal lymph nodes for rectal cancers involving the anal canal?

One of my residents recently told me that I should treat the inguinal nodes for low lying rectal cancers based on recommendations on the MedNet. I realized this is an old post, but I would like to add a nice reference that really convinced me that there is probably minimal benefit to treating inguin...

We used to recommend avoiding inguinal nodal irradiation based on the study that we published as quoted above. Part of the reason was that in the 3D era the genitalia would get too much dose. However, using IMRT we are able to effectively spare these areas, shifting the risk benefit ratio back in fa...

I agree in IMRT era we routinely treat inguinal nodal region for low lying rectal cancer involving anal canal

I do not perform elective nodal irradiation of lymph nodes in low lying rectal cancers. If there is clinical evidence (CT, PET, clinical), then I recommend biopsy. If positive then I would radiate. There is not great evidence for this practice, but there is a retrospective review from MDACC that sho...