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Disease staging
• To determine:
• Tumor location
• Tumor size
• Nodal involvement
• Distant Metastasis
• Primary tumor :
• Clinical examination, preferentially under anesthesia
• Nodes
• Clinical examination
• Fine needle aspiration inguinal
• Radiological TN staging : MRI
M staging : CT
Note : FDG-PET, inguinal sentinel N biopsy : investigational
Treatment of localized anal cancer
• Prior to mid-1980’s: abdominoperineal resection
as standard treatment
• Nigro et al:
XRT 30 Gy + 5 FU Mito C (3 patients)
•
2 AP resection tumour sterilised
•
1 refusing surgery in complete clinical
remission
No need for APR?