Treatment of squamous cell carcinoma of anal canal is?
Cancers of the anal canal can be divided into those affecting the anal margins (distal to the dentate line) and those affecting the anal canal (proximal to the dentate line). Treatment of the anal epidermoid or squamous cell carcinoma Ca of anal margin is treated in similar way to the squamous cell carcinoma of the skin and other locations because adequate surgical margins can usually be achieved without resecting the anal sphincter Wide local excision is adequate. Epidermoid cancer occurring in the anal canal cannot be excised locally without destroying the sphincter so the first line therapy is Chemoradiotherapy (nigro protocol) More than 80% are cured by chemoradiation. If any residual tumor is left behind after chemoradiation or recurrence occurs an APR is performed Also know Chemotherapy used is combination of 5 FU and mitomycin C. Ref: Bailey & Love 25/e, page 1269; Schwaz 9/e, Page 1053.
Cisplatin based chemotherapy followed by radical radiotherapy
Abdominoperineal resection
Radical radiotherapy
Radical radiotherapy followed by mitomycin-c based chemotherapy