Assuming that inguinal nodes are from anal SCC and the rectal tumor is pMMR, from the Medical Oncology perspective, starting treatment with Mitomycin-C and capecitabine concurrently with radiation would make sense. The patient might be benefited from systemic chemo (e.g., FOLFOX, or FOLFIRINOX if hi...

If the patient has intact bowel/anal sphincter function at baseline, I’d favor an organ-preserving approach. I’d treat with standard pelvic + inguinal chemoradiation with a dose/fractionation scheme isoeffective with 45 Gy in 25 fractions targeting pelvis/inguinals and a dose isoeffectiv...

I've treated a couple of cases like this and would approach this case very differently from the posted answers. I think it is important to remember: Unresectable anal cancer is curable with RT and appropriate chemotherapy. Stage III rectal cancer is curable with preoperative RT, and chemotherapy...

Great discussion.Just want to add one possible scenario.In the clinic, for this type of situation, we usually would like to biopsy the inguinal lymph node and place fiducial in the node. The inguinal lymph node could be from the distal rectal adenocarcinoma especially if the distal rectal adenocarci...

Given the presentation of concurrent low-rectal adeno ca and anal SCC, the patient would not be a surgical candidate, therefore his treatment would be chemo and radiation, hoping there is no distant metastatic disease. It would be important to know the size, HPV status, and stage of anal cancer...

How would you treat a synchronous low rectal adenocarcinoma and anal squamous cell carcinoma with involved pelvic and inguinal nodes? The question does not provide details about the clinical stage and location, histopathologic details, MMR, and HPV status of both the rectal and anal tumors desc...