The treatment of choice for the management of carcinoma of the anal canal is

Nowadays, primary treatment is by chemoradiotherapy , the chemotherapy sually including a combination of 5-fluorouracil (5-FU) with mitomycin C or cisplatin. The surgeon, however, has an impoant role in management: initial diagnosis is surgical; small marginal tumours are still best treated by local excision; radical surgery is indicated in those with persistent or recurrent disease following CMT; and a defunctioning stoma may be indicated for those in whom treatment and disease regression is associated with radionecrosis, incontinence or fistula. Other anal malignancies Adenocarcinomata within the anal canal are usually extensions of distal rectal cancers. Rarely, adenocarcinoma may arise from anal glandular epithelium or develop within a longstanding (usually complex) anal fistula; treatment is as for low rectal cancers but prognosis is less good. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1269