Is elective inguinal radiotherapy necessary for locally advanced XXXX invading anal canal?

@entity1 @entity5 @entity1817 @entity3 @entity420
UNASSIGNED: BackgroundWe investigated whether routine elective irradiation of a clinically negative @entity1817 ( @entity1817 ) is necessary for @entity1 with locally advanced @entity5 and anal canal invasion (ACI).MethodsWe reviewed retrospectively 1,246 @entity1 with locally advanced @entity420 managed using preoperative or postoperative chemoradiotherapy and radical surgery between 2001 and 2011. The @entity1   @entity1817 was clinically negative at presentation and @entity1817 irradiation was not performed. ACI was defined as the lower edge of the @entity5 being within 3 cm of the anal verge. @entity1 were divided into two groups, those with ACI (n  =  189, 15.2%) and without ACI (n  =  1,057, 84.8%).ResultsThe follow-up period was a median of 66 months (range, 3  142 months). Among the 1,246 @entity1 , 10 developed @entity1817 recurrence; 7 with ACI and 3 without ACI. The actuarial @entity1817 recurrence rate at 5 years was 0.7%; 3.5% and 0.2% in @entity1 with and without ACI, respectively (p  <  0.001). Isolated @entity1817 recurrence occurred in three @entity1 , all of whom had @entity3 . These three @entity1 received curative intent local treatments, and one was alive with no evidence of disease 10 years after @entity1817 recurrence. Salvage treatments in the other two @entity1 controlled successfully the @entity1817 recurrence for >5 years, but they developed second @entity5 or pelvic and distant recurrences. Seven @entity1 with non-isolated @entity1817 recurrence died of disease at 5  22 months after @entity1817 recurrence.ConclusionThe low @entity1817 recurrence rate even with ACI and the feasibility of salvage of isolated @entity1817 recurrence indicated that routine elective @entity1817 irradiation is not necessary for @entity5 with ACI.
