How would you mange true anal margin squamous cell carcinoma (with no involvement of anal canal) if wide local excision cannot be done and chemoradiation therapy is being used instead?

There are many facets to this question. First, it is critical to know that this is a surgical disease, and radiation therapy should only be used as a last resort. If there is no involvement of the anal canal, that strengthens the argument for the use of surgery. The situation is rare when radiation ...

I agree with Joel. Sometimes clinicians are tempted to treat the mesorectal nodes and internal iliac nodes because that is what we do for tumors involving the anal canal. However as Joel points out, the drainage goes through the inguinals to the external iliacs in most cases. If there is an unusual ...