How do you treat anal adenocarcinoma?

First of all you have to define what you are dealing with. Adenocarcinoma of the anal canal is a rare condition arising from anal glandular tissue. There is no IHC marker or definitive histologic finding that can differentiate it from rectal cancer with extension into the anal canal. The suggestive finding on path is adenocarcinoma with overlying normal squamous mucosa and the clinical finding is that it is essentially confined to the anal canal. It is not important to differentiate it from rectal cancer for clinical decision making because the treatment of choice for both is preoperative chemoradiation followed by APR and adjuvant FOLFOX chemotherapy, but the prognosis is different.

The two diseases have a different prognosis based on our 2...