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Thursday, December 27, 2012

Anal Cancer

Question: What is the treatment of Anal Cancer?
Answer See Below:
Anal Canal (above Dentate) - usually chemoradiation

    Adenocarcinoma - same concept as rectal cancer (if T1 and small < 3cm then WLE) - if not APR
    Squamous/Basaloid (cloacogenic), mucoepidermoid - NIGRO, if recurrent then APR
    Melanoma - no difference between APR and WLE
Anal Margin (below dentate) - usually excision
    Squamous of Basal - same concept as skin cancer, WLE although made need APR if sphnicters involved
    Bowen's disease - WLE with clear margins because this is malignant
    Paget's Disease - intractable itching, positive PAS, 1/3 with concurrent rectal cancer - WLE
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