Anal carcinoma


Work-up anal carcinoma:

-Rectoscopy with biopsies
-Optional: Endoscopy ultrasound to inspect transmural invasion.
-Optional: FDG-PET could be useful for stage evaluation and for a radiation plan.

Treatment anal carcinoma based on stage:


-Anal Intraepithelial Neoplasia (AIN): yearly check
-AIN 2/3: treatment with electro- or infraredcoagulation.
-Peri-anal AIN 2/3: Imiquimod

-Curative surgery 1 cm excision margin

Curative treatment stage II or highr without metastases
-Small (≤ 2 cm) and superficial tumours (≤ 1 cm infiltration depth) and immunocompromised patient only radiotherapy is an option

Metastasized ziekte:
-Cisplatin and 5-FU


Alam NN, White DA, Narang SK, Daniels IR, Smart NJ. Systematic review of guidelines for the assessment and management of high-grade anal intraepithelial neoplasia (AIN II/III). Colorectal Dis. 2016;18(2):135‐146. doi:10.1111/codi.13215

Long KC, Menon R, Bastawrous A, Billingham R. Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia. Clin Colon Rectal Surg. 2016;29(1):57‐64. doi:10.1055/s-0035-1570394