How would you manage a localized small cell carcinoma of the anal canal without nodal or distant disease?

High-grade, poorly differentiated neuroendocrine carcinoma (NEC) of the anorectum is a highly aggressive malignancy associated with a very poor prognosis.

For truly localized disease (FDG PET negative for extrapelvic and nodal disease), the outcomes are still poor. The majority of patients with loco...