Anal cancer
ICD-10 C21 · ICD-11 2C00

Early Anal Margin Cancer (cT1N0M0) After Local Excision with Inadequate Histological Clearance

Clinical Scenario

Early anal margin cancers (stage cT1N0M0) are typically treated by local excision, with the intent to achieve a histological clearance margin greater than 1 mm while preserving the anal sphincter. This protocol applies when that clearance goal was not met.

Prior Treatment — Failure Condition

Local excision of the anal margin tumour was performed aiming to achieve a histological clearance of >1 mm without damage to the anal sphincter muscle. This next step is triggered when that target was not reached — specifically, when the final histological margin is ≤1 mm.

Next Step — Treatment Approach

When the histological margin is ≤1 mm after local excision, a postoperative approach using low-dose radiation with concurrent chemotherapy is considered. The complete protocol details are available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2021.06.015

Early anal margin cancers (cT1N0M0) can be treated definitively by local excision.

The majority of these are early anal margin cancers (cT1N0M0).

CRT is recommended for anal margin cancers (T1N0M0) if the margin is ≤1 mm [III, B].

Anal margin SCC is a HPV-related cancer and exquisitely RT-sensitive, and should be considered for low-dose RT with concurrent ChT.

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