A 55-year-old man undergoes proctoscopy and is found to have anal squamous cell carcinoma 3 cm in diameter confined to the anal canal without lymph node involvement. The preferred treatment is:

• A Abdominoperineal resection
• B Wide local excision alone
• C Radiotherapy alone
• D Nigro protocol (synchronous chemoradiotherapy) ✓

Explanation

Anal squamous cell carcinoma is treated with the Nigro protocol — concurrent chemoradiotherapy using 5-fluorouracil, mitomycin C, and external beam radiotherapy — achieving complete response in over 80% of cases while preserving sphincter function. Abdominoperineal resection with permanent colostomy was formerly the standard but is now reserved for salvage after chemoradiotherapy failure. Wide local excision is insufficient for lesions greater than 2 cm. Radiotherapy alone achieves inferior results compared to combined modality treatment.

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.