White R, et al. - In this NCDB-driven, retrospective study of cases with AJCC stage 1-3 anal adenocarcinoma diagnosed between 2004-2015, researchers analyzed treatment trends and outcomes in the current time from 2004-2015 with respect to chemoradiation and surgery. They identified 1729 patients as eligible for this study. They observed median survival rates of 78, 83, 92, and 46 months while performing analysis across patients treated with surgery alone, surgery followed by adjuvant chemoradiation, neoadjuvant chemoradiation followed by surgery, and chemoradiation alone, respectively. In this study, improved overall survival was evident with the incorporation of surgery into the initial management of anal adenocarcinoma when compared to chemoradiation alone, despite the omission of surgery in up to 50% of the cases logged. These results support earlier studies published prior for surgery to be included in the definitive management of anal adenocarcinoma.