Table 3.

Main conclusion from each study included in this systematic review.

	From This Study	Main Conclusions
1	Peiffert et al. (2012) [8]	No advantage for induction chemotherapy (ICT) or HD radiation boost use
2	Bertelson et al. (2015) [9]	For stage II AA patients CRT followed by APR is the treatment choice, with curative resection offering no significant long-term DFS outcomes
3	Franklin et al. (2016) [10]	Consider more aggressive therapy since AA has worse prognosis than SCCA and RA
4	Su et al. (2017) [11]	Prophylactic inguinal nodal treatment necessary for AA patients, even if negative ILNs
5	McKenna et al. (2019) [12]	Increased mortality associated with non-surgical management thus AA patients need MDT evaluation and surgery referral
6	Leong et al. (2019) [13]	Treatment of choice is multimodal with neoadjuvant CRT followed by APR (CRT + S)
7	Wang et al. (2019) [14]	AA has worse prognosis than RA and T staging criteria for anal carcinoma may not be valid for AA
8	Lewis et al. (2019) [15]	Trimodality therapy offers better survival outcomes than CRT alone, specifically CRT followed by APR within 6 months
9	Li et al. (2019) [16]	CRT followed by surgery (CRT + S) associated with significant OS benefit
10	Malakhov et al. (2019) [17]	AA tends to be treated like rectal cancer using neoadjuvant CRT and a more aggressive approach necessary with surgery, particularly APR, being important
11	Wegner et al. (2019) [18]	Improved OS by incorporating surgery in AA management compared to CRT alone
12	Park (2020) [19]	CRT given preoperatively with surgical resection might maximise OS outcomes
13	Gogna et al. (2020) [20]	Survival outcomes significantly improved with surgery
14	Yasuhara et al. (2021) [21]	Outcomes Crohn’s disease-associated patients with larger sized AA tumours are significantly poorer. Improved outcomes of CRT + S compared to S only.
15	Chatani et al. (2021) [22]	No overall survival difference between local excision or APR in combination with CRT