الفهرس 
Assessment of anal canal cancer management in the National cancer Institute
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Abstract
Background: the treatment of anal canal carcinoma had been changed radically from APR with permanent colostomy to organ preserving CCRTH. Aim: This retrospective study will evaluate the National cancer Institute (NCI) lines of treatments, response and survival for this rare gastrointestinal malignant disease. Our results will be correlated with the published to draw recommendations either to change or emphasize the ongoing trends of surgery, chemotherapy and / or radiation therapy. Methods: We collected and analyzed retrospective data on the clinical presentation, laboratory investigations, radiologic imaging, pathology and operative details of all patients diagnosed with pathological and clinical proved anal cancer that underwent curative surgical or CCRTH in NCI from 2008 to 2013. Results: In this study, the mean age of the patients reviewed was 52.9 years, age range from 23 years to 82 years old and there was a slight predominance of women. The main complaint was bleeding (44.4%) followed by pain (33.3%) and mass (22.2%). The main colonscoping finding was mass (59.3%) followed by ulcer (33.3%). biopsy was mainly SCC (88.9%) followed by adenocarcinoma (7.4%) and by undifferentiated carcinoma (3.7%). Twenty four (88.9%) of the 27 patients were treated with a definitive ccrth regimen 9 (33.3) of them didn{u2019}t respond and were followed by salvage APR 1 of them followed by adjuvant cth. The other 3 (11.1%) patients were treated with Neoadjvant ccrth followed by APR and adjuvant CTH .Four (14.8%) of 27 patient received adjuvant CTH