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With the aim to compare results of inguinal lymphadenectomy (ILA) and chemoradiation (CRT) for inguinal lymphnodes metastases (mILN) from anal carcinoma (AC) retrospective study was undertaken.Of 146 consecutive patients (1996-2009) with AC 15 (10.3%) had synchronous mILN and six had metachronous mILN. All 21 patients were women at mean age 58 ± 10.8 (range 41-79). ILA wasprimary treatment in four patients with synchronous mILN and four patients with metachronous mILN. CRT was used in 11 cases of synchronous mILN and two cases of metachronous mILN.Morbidity rate after ILA was 50% and local control (LC) rate at 5 years was 6/8 (75%). Two local recurrence treated by CRT but secondary LC achieved for one. No significant toxicity developed after CRT and complete response of mILN was achieved in 9/13 (69.2%), but only 6/13 (46.2%) had LC at 3 year. No difference in overall 5-year survival between ILA and CRT was obtained: 43.0% vs 47.0% (P = 0.9). Tendency toward better 5-year survival of treatment for metachronous comparing to synchronous mILN was found: 60.0% vs 40.8% (P = 0.1).The effectiveness of ILA and CRT for mILN is similar. Time of mILN appearance is most important factor of survival.