A 70-year-old man presents with anal canal squamous cell carcinoma (T2N0) confirmed on biopsy. What is the standard curative treatment as established by the Nigro protocol?
- A Abdominoperineal resection (APR) alone
- B Combined chemoradiation with 5-FU and mitomycin C (Nigro protocol) ✓
- C Radical radiotherapy alone to 60 Gy
- D Wide local excision with inguinal lymph node dissection
Correct answer: B. Combined chemoradiation with 5-FU and mitomycin C (Nigro protocol)
Explanation
The Nigro protocol (concurrent chemoradiation using 5-fluorouracil infusion plus mitomycin C with external beam radiotherapy) is the standard of care for anal canal squamous cell carcinoma, achieving 5-year local control and sphincter preservation rates exceeding 80%. APR is now reserved for residual/recurrent disease after chemoradiation failure. Wide local excision is inadequate for invasive carcinoma. This paradigm shift from surgery to non-surgical definitive treatment was established by Wayne Nigro in 1974.
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.