title: Surgical considerations in anal cancer.
abstract: SCC of the anus is rare; however, the surgeon is bound to encounter some of these patients during his or her career. It is important that the anatomic location and the histology be defined because the initial treatment may initially differ. Multimodality therapy is the treatment of choice in SCC of the anal canal, with surgery reserved for persistent or recurrent tumors. Multimodality therapy can be used selectively in SCC of the perianal skin, especially in large bulky tumors, followed by definitive surgery. Nevertheless, the initial treatment of perianal neoplasms is surgical therapy. In general, inguinal node metastases are treated with chemoradiation. In highly selected patients, groin dissections are performed, but this procedure is not routine.
authors.affiliation: Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, TX 77030, USA. jskibber@mdanderson.org
authors.forename: John
authors.initials: J
authors.lastname: Skibber
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rodriguez-Bigas
authors.forename: Philip H
authors.initials: PH
authors.lastname: Gordon
mesh_terms: D001005:Anus Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018714:Radiotherapy, Adjuvant