A 63yo male has anal canal carcinoma with no evidence of spread to the pelvic wall, pelvic muscles or lymph nodes. This is typically managed by?

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. A 63yo male has anal canal carcinoma with no evidence of spread to the pelvic wall, pelvic muscles or lymph nodes. This is typically managed by?

a. Resection of the sigmoid colon

b. Right hemicolectomy

c. Left hemicolectomy

d. Transverse colectomy

e. Internal sphincterotomy

f. CT guided drainage

g. Diverticulectomy

h. Transverse colostomy

i. Chemotherapy and

radiatherapy

j. Abdominal perineal resection

Ans. The key is I. Chemotherapy and radiotherapy. [This is T1 N0 M0 that is stage 1 cancer. (http://www.cancer.gov/types/anal/hp/anal-treatment-pdq#section/_45).

BUT we don’t have tumor size here and sphincter information. However surgery can be avoided To preserve sphincter. Chemo radiation is preferred ohcm 633; 9th ed].