Surgical management of primary anorectal melanoma

• Published in: British journal of surgery Vol. 91; no. 9; pp. 1183 - 1187
• Main Authors: Pessaux, P., Pocard, M., Elias, D., Duvillard, P., Avril, M.-F., Zimmerman, P., Lasser, P.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.09.2004; Wiley
• Subjects: Adult; Aged; Aged, 80 and over; Anus Neoplasms - surgery; Biological and medical sciences; Dermatology; Disease-Free Survival; Female; General aspects; Humans; Male; Medical sciences; Melanoma - surgery; Middle Aged; Neoplasm Recurrence, Local; Rectal Neoplasms - surgery; Retrospective Studies; Survival Analysis; Treatment Outcome; Tumors of the skin and soft tissue. Premalignant lesions; Medicine; Primitive; Treatment; Surgery; Malignant melanoma; Primary; Anorectal; Malignant tumor
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.4592

Background: This aim of this study was to analyse outcome after surgery for primary anorectal melanoma and to determine factors predictive of survival. Methods: Records of 40 patients treated between 1977 and 2002 were reviewed. Results: Twelve men and 28 women of mean age 58·1 (range 37–83) years were included in the analysis. Overall and disease‐free survival rates were 17 and 14 per cent at 5 years. Median overall survival was 17 months and disease‐free survival was 10 months. The 5‐year survival rate was 24 per cent for patients with stage I tumours, and zero for those with stage II or stage III disease. There was no significant difference in overall survival after wide local excision (49 and 16 per cent at 2 and 5 years respectively) and abdominoperineal resection (33 per cent at both time points). In patients with stage I and stage II disease, there was a significant association between poor survival and duration of symptoms (more than 3 months), inguinal lymph node involvement, tumour stage and presence of amelanotic melanoma. Conclusion: Anorectal melanoma is a rare disease with a poor prognosis. Wide local excision is recommended as primary therapy if negative resection margins can be achieved. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Radical excision confers little benefit