Management of Localized and Locally Advanced Anal Cancer.

The initial evaluation and workup of anal canal cancer and perianal cancer is the same, but treatment strategies differ based on stage and location of disease. Chemoradiation remains the cornerstone of treatment for anal canal squamous cell carcinoma (SCC), while surgery is typically reserved for persistent or recurrent disease. Perianal SCC can be treated with local excision for early stage disease (T1N0, select T2N0) or chemoradiation for later stages. Despite advancements in treatment strategies, excellent tumor response to neoadjuvant therapy, and surgical technique, additional work is needed to continue to improve outcomes and mitigate treatment-related toxicities.