This protocol addresses patients with T1,N0 well-differentiated perianal (anal margin) cancer that does not involve the sphincter. It also applies to select patients with smaller T2,N0 perianal cancers that similarly do not involve the sphincter.
The tumour's location at the anal margin, its well-differentiated histology, the absence of nodal involvement (N0), and the lack of sphincter involvement are the defining features that determine how this presentation is approached.
Primary management for this presentation is surgical, directed at obtaining adequate resection. The specific technique, margin requirements, and criteria that distinguish T1 from T2 management are defined in the full protocol.
The complete margin definitions, surgical guidance, and evidence-based decision criteria are available in the structured regimen below.
The primary objective is achieving adequate, histologically negative surgical margins. Full criteria defining adequacy are specified in the complete protocol.
DOI: 10.6004/jnccn.2023.0030