Standard Treatment Abdominal-perineal resection has been the treatment of choice in the past. Deciding whether to perform this operation may depend on whether the physical examination or the CT, ultrasound or MRI scans find that the perirectal lymph nodes are involved. The need for a biopsy of perirectal lymph nodes to differentiate between Stage II and Stage III disease may not be verifiable without surgery.
Chemotherapy and radiation given before surgery may not only improve the long-term results, but also permit sphincter preserving surgery by shrinking the tumor substantially before the operation.
Five-Year Survival 60 percent
Investigational
• Trials to evaluate postoperative external beam radiation to the involved area, which may improve local control
and survival, are ongoing.
• Chemotherapy after surgery is also being evaluated.
Stage IIIB
TNM T4, N1, M0 or any T, N2-3, M0
The cancer has spread to the internal iliac and/or groin lymph nodes on one or both sides or has spread to adjacent organs such as the vagina, urethra or bladder. Metastatic disease to the groin (inguinal) nodes is a poor prognostic sign and markedly reduces the chance for cure, although cure is still possible.
