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Localised anal squamous cell carcinoma (stage I to III): lines of therapy

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5 standard-of-care settings across 5 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersRisk group
Screening, prevention and diagnosis1·
Early / localised1·
Locally advanced·1
Second line1·
Other settings1·

Screening, prevention and diagnosis

SubgroupSettingApproachProducts and trialsEvidence
All comersStagingPelvic MRI, PET-CT, examination of the groins, HIV testing and HPV or p16 status; biopsy of suspicious groin nodes.92

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersStage I to IIIIntensity-modulated radiotherapy with concurrent fluorouracil (or capecitabine) and mitomycin, dose scaled to stage (ACT II, RTOG 98-11); small perianal tumours may be excised alone.93

Locally advanced

SubgroupSettingApproachProducts and trialsEvidence
Risk groupHigh-risk locally advanced diseaseTrials of dose escalation (PLATO ACT5) and adjuvant nivolumab (EA2165); standard care remains chemoradiotherapy alone.93

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersPersistent or recurrent diseaseSalvage abdominoperineal resection with permanent colostomy; inguinal node dissection or radiotherapy for isolated groin recurrence.40

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersResponse assessmentClinical assessment at 26 weeks; biopsy only if disease persists or grows, because regression continues for months (ACT II).73

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.