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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Advances in the Management of Anal Cancer
Diana R Julie1, Karyn A Goodman2
1Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. diana.r.julie@gmail.com.
Abstract:
Although anal squamous cell carcinoma (ASCC) is an uncommon malignancy, its incidence has been increasing markedly in recent decades due to its association with human papilloma virus (HPV) infection. The well-established standard of care for localized ASCC consists of the combination of 5-fluorouracil (5FU) and mitomycin (MMC) chemotherapy, concurrent with external beam radiation therapy (EBRT). However, newer techniques are being actively pursued, including the use of newer radiation therapy (RT) technologies, such as intensity-modulated radiation therapy (IMRT). The areas of debate and development include the dosing and timing of MMC delivery, the role of cisplatin chemotherapy as an alternative to MMC, the replacement of the standard 96-h infusion of 5FU with oral capecitabine, the use of targeted chemotherapy agents, and the duration and dose of RT.
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