Would you treat rectal squamous cell carcinoma the same as rectal adenocarcinoma, stage for stage?

No, I will treat rectal squamous cell carcinoma the same as anal squamous cell carcinoma, with definitive chemoradiation with 5FU/mitomycin. If the cancer invades the posterior vaginal wall or prostate, I will also include external ilac nodes. If the tumor involves lower rectum/anus, I will also treat inguinal nodes.

Our group has published a paper in 2016 using SEER data to compare outcomes between rectal squamous cell carcinoma and adenocarcinoma (Chiu, et al. Cancer Medicine 2016). We found th...

Location is everything. If the tumor approaches the anal canal, I would treat like answered above, with combined chemo/RT appropriate for squamous cell cancer of the anus. However, if the tumor starts a significant distance from the dentate line, I would consider preoperative radiation and chemotherapy. Control rates with a nonsurgical technique are not 100%. Data for specific locations within the rectum are lacking. If organ sparing surgery is available, use it. And like noted above, be generou...

I have received a number of referrals from gastroenterologists for patients with “rectal SCC”. DRE usually reveals a typical mass originating in the anal canal and bridging the dentate line. I believe the “mislabeling” may occur during colonoscopy, when these are viewed by a retroflexed colonoscope. I do not have any data to support this (just experience) but I would estimate this to have been the case 80% of the time.

CRT like anal SCC