What treatment options would you consider for an anorectal adenocarcinoma following long course chemoRT, mFOLFIRINOX, and APR followed by an incomplete re-resection of a local recurrence?

A more comprehensive characterization of this case will be crucial.

Critical information includes the initial disease presentation and stage, treatment timeline, tumor response to each therapeutic modality (radiation, chemoradiation, and systemic chemotherapy), results of preoperative imaging, surgi...

NGS and details on the response to each modality used so far will be needed to personalize the response to a case like this. Generally, options will include additional resection (exenteration, maybe), palliative systemic options (clinical trials; chemotherapy depending on details/response to FOLFIRI...

Assuming you got maximal dosing of radiation delivered the first time (50 Gy), the only option is re-resection for definitive treatment vs systemic therapy for disease control, but not eradication. This needs multidisciplinary input, including plastics, colorectal surgery, and radiation oncology, in...