Can you skip elective inguinal treatment in PET negative squamous cell carcinoma of anal canal?

This is an interesting question. There are a few small series that suggest that the negative predictive value of a PET-CT may be quite high (100% in the study by Mistrangelo, IJROBP, 2012). However, the gold standard in these results was sentinel lymph node biopsy, not inguinal lymph node dissection, and we do not have prospective data demonstrating the safety of avoiding the inguinal regions in the treatment of these patients. Furthermore, in a clinically node negative patient, the dose to the ...

If regional node prophylactic treatment is given , I would favor 45 Gy / 5 weeks,since this time/dose regimen has been clinically and statistically well established as very effective for control of sub local disease in lymph nodes by Fletcher et al —and ,any other dose /time relationships are not as well documented for control of sub clinical disease control in nodes . I would favor prophylactic treatment of nodes for anal ca since with IMRT morbidity is low —and later recurrence in nodes is ver...