The currently accepted first line treatment for epidermoid anal cancer is chemoradiotherapy (CRT). Tumour size and adjacent organ involvement are the key in the pretreatment assessment for T1-T4 tumours respectively. Residual or recurrent disease following initial CRT, is best treated by salvage anorectal excision. Pathological staging systems of resections were historically validated when surgery was the primary treatment and are therefore in need of revision. We propose a new pathological staging system for salvage anorectal excision specimens to allow improved prognostic guidelines postoperatively. © 2007 Blackwell Publishing Ltd.