A 55-year-old woman presents with a 2 cm anal squamous cell carcinoma (SCC) with inguinal lymph node involvement. The TNM stage is T2 N1 M0. The standard of care treatment is:
- A Chemoradiotherapy (Nigro protocol): 45–59 Gy radiotherapy with concurrent 5-fluorouracil and mitomycin C ✓
- B Abdominoperineal resection (APR)
- C Local excision with 1 cm margins
- D Inguinal lymph node dissection followed by chemotherapy
Correct answer: A. Chemoradiotherapy (Nigro protocol): 45–59 Gy radiotherapy with concurrent 5-fluorouracil and mitomycin C
Explanation
Anal SCC (squamous cell carcinoma of the anal canal) is treated with the Nigro chemoradiotherapy protocol as primary curative therapy — radiotherapy (45–59 Gy) plus concurrent 5-FU and mitomycin C. This organ-preserving approach achieves 80–90% complete response for early disease and avoids APR. Surgery (APR) is reserved for residual or recurrent disease after chemoradiotherapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.