Lower GI 2017

Disease staging

• To determine: • Tumor location • Tumor size

• Nodal involvement • Distant Metastasis • Primary tumor : • Clinical examination, preferentially under anesthesia • Nodes • Clinical examination • Fine needle aspiration inguinal • Radiological TN staging : MRI M staging : CT

Note : FDG-PET, inguinal sentinel N biopsy : investigational

Treatment of localized anal cancer • Prior to mid-1980’s: abdominoperineal resection as standard treatment • Nigro et al: XRT 30 Gy + 5 FU Mito C (3 patients) •  2 AP resection tumour sterilised •  1 refusing surgery in complete clinical remission No need for APR?

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