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Surgical therapy for anorectal melanoma
Kelli M Bullard1, Todd M Tuttle, David A Rothenberger
1Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
Journal of the American College of Surgeons
|February 22, 2003
Summary
Wide local excision is recommended for anorectal melanoma, offering similar survival outcomes to abdominoperineal resection (APR). This approach does not increase local or regional recurrence risks for anorectal melanoma patients.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Melanoma Research
Background:
- Anorectal melanoma is a rare, highly lethal cancer.
- Radical resection was historically the standard treatment.
- Wide local excision is proposed as an alternative initial approach.
Purpose of the Study:
- To review outcomes of wide local excision versus abdominoperineal resection (APR) for localized anorectal melanoma.
- To compare survival and recurrence rates between surgical methods.
Main Methods:
- Retrospective chart review of patients undergoing resection for anorectal melanoma (1988-2002).
- Evaluation of overall survival, disease-free survival, and recurrence patterns (local, regional, systemic).
Main Results:
- 15 patients underwent curative surgery: 11 wide local excision, 4 APR.
- Long-term survivors (≥5 years) all had initial wide local excision.
- No significant differences in survival or recurrence between wide local excision and APR groups.
- Distant metastases were common in both groups (75% APR vs. 36% local excision).
Conclusions:
- Systemic recurrence is common in anorectal melanoma, irrespective of initial surgical approach.
- Wide local excision is a safe alternative to APR, without increased local or regional recurrence risk.
- Abdominoperineal resection (APR) does not offer a survival advantage over wide local excision for anorectal melanoma.