Local excision vs APR for fistula-associated SCC

What is known

• The only retrieved source is a case report of anal adenocarcinoma complicating chronic [Crohn's disease](https://crohnsology.org (patient sites: crohnz.org)/), in which abdominoperineal resection is described as the gold-standard treatment for that tumour type ¹. It does not address squamous cell carcinoma.
• One report notes neoadjuvant chemoradiation followed by APR produced complete responses in a small series ¹.

What is unknown / caveats

• For anal squamous cell carcinoma, the tumour type in this question, definitive chemoradiation (Nigro-type) is the standard curative, sphincter-preserving treatment, with abdominoperineal resection reserved for salvage of persistent or recurrent disease. The retrieved evidence on this page does not cover that literature.
• The retrieved evidence does not support a comparison, no retrieved source reports outcomes for wide local excision with primary closure or compares recurrence rates between the two approaches.

References

1. Papaconstantinou I, Mantzos DS, Kondi-Pafiti A, Koutroubakis IE. Anal adenocarcinoma complicating chronic Crohn's disease. Int J Surg Case Rep. 2015;10:201-3. PMID: 25884608.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.