Michael P Jones1,2, Susan Carroll3,4, Jarad Martin5,6, Richard Hillman7, Andrew Grulich8, Dianne O'Connell5,9,10, Christopher Young4,11, Isobel Mary Poynten8. 1. Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada. mpjones85@gmail.com. 2. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia. mpjones85@gmail.com. 3. Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia. 4. Royal Prince Alfred Hospital, Camperdown, NSW, Australia. 5. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia. 6. Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia. 7. St Vincent's Hospital, Darlinghurst, NSW, Australia. 8. Kirby Institute, University of New South Wales, Kensington, NSW, Australia. 9. Cancer Research Division, Cancer Council NSW, Woolloomooloo, NSW, Australia. 10. Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia. 11. The University of Sydney, Camperdown, NSW, Australia.
Abstract
PURPOSE: The optimal management of early squamous cell carcinoma of the anal canal (AC) is yet to be determined. This study investigated current practice in the management of early AC. METHODS: A patterns of care survey was completed by Australian surgeons and radiation oncologists. Specific topics addressed were as follows: geographical location of practice, staging of disease, treatment approaches to T1N0 tumours and grade 3 anal intra-epithelial neoplasia (AIN3) lesions, radiotherapy planning, toxicities, follow-up and clinical trial involvement. RESULTS: Sixty-four responses were obtained. For the management of T1N0 disease, half the respondents recommended standard dose chemo-radiotherapy (CRT) and one third recommended wide local excision (WLE). For the management of AIN3, half recommended WLE while a quarter advocated observation. CONCLUSIONS: This study reveals a significant variation in the management of early AC. The development of guidelines specific to the treatment of early AC could standardise treatment while further research is required to define the optimal management of T1N0 AC and AIN.
PURPOSE: The optimal management of early squamous cell carcinoma of the anal canal (AC) is yet to be determined. This study investigated current practice in the management of early AC. METHODS: A patterns of care survey was completed by Australian surgeons and radiation oncologists. Specific topics addressed were as follows: geographical location of practice, staging of disease, treatment approaches to T1N0 tumours and grade 3 anal intra-epithelial neoplasia (AIN3) lesions, radiotherapy planning, toxicities, follow-up and clinical trial involvement. RESULTS: Sixty-four responses were obtained. For the management of T1N0 disease, half the respondents recommended standard dose chemo-radiotherapy (CRT) and one third recommended wide local excision (WLE). For the management of AIN3, half recommended WLE while a quarter advocated observation. CONCLUSIONS: This study reveals a significant variation in the management of early AC. The development of guidelines specific to the treatment of early AC could standardise treatment while further research is required to define the optimal management of T1N0 AC and AIN.
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