How would you approach neoadjuvant radiation therapy for an adenocarcinoma of the anus involving the perirectal skin in a patient with a history of total proctocolectomy with an ileoanal J-pouch anastomosis?

I think it is likely that this is a patient with UC. The fact that this is an adenocarcinoma and that it involves the peri-anal skin with a possible positive iliac node means that there is no possibility of preserving the sphincter using surgery. The tumor is likely arising in the residual bowel and...

With an adenocarcinoma involving the anus and perirectal skin, likely this patient would need an APR and permanent ileostomy after neoadjuvant treatment. I suppose there is a chance they could have a complete clinical response but this case seems like a pretty aggressive cancer so I wouldn't expect ...

When treating adenocarcinoma of the anus in a patient with a history of total proctocolectomy with an ileoanal J-pouch anastomosis due to ulcerative colitis, it is essential to consider the potential risks and benefits of neoadjuvant radiation therapy carefully. I may recommend TNT.

In this case, re...