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Updated: Jun 3, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Treatment outcomes of anorectal melanoma
Byung Min Choi1, Hyoung Ran Kim, Hae-Ran Yun
1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Purpose:
An anorectal melanoma (AM) is a very rare tumor. However, sufficient data supporting effective surgical options for the disease do not exist. This retrospective review aimed to analyze treatment outcomes for an AM.
Methods:
From June 1999 to December 2008, we retrospectively reviewed a prospectively collected consecutive series of 19 patients who had undergone a surgical resection for an AM at a single institute. Surgical method and clinicopathological factors were analyzed.
Results:
The median age was 61.4 years (range, 46 to79 years). Main symptoms were an anal mass, hematochezia, perianal pain, tenesmus, fecal incontinence, and bowel habit change. The average duration of symptoms before diagnosis was 7.8 months (range, 1 to 36 months). S-100 and HMB-45 were positive in all patients, even in non-melanin pigmentation. There were 12 abdominoperineal resections (APRs) and 7 wide local excisions (WEs). The APR showed longer overall survival when compared with the WE (64.1 months vs. 10.9 months, P < 0.001). No patients who underwent a WE survived more than 13 months.
Conclusion:
A high index of suspicion is necessary to establish the diagnosis for an AM in patients with anal symptoms, and S-100 and HMB-45 can be useful markers for an AM. Even with the small number of cases and the short follow-up, our data suggest that an APR for an AM may provide longer survival than a WE.
Insights
Abdominoperineal resection (APR) may offer longer survival for anorectal melanoma (AM) patients compared to wide local excision (WE). Early diagnosis using S-100 and HMB-45 markers is crucial for this rare anal cancer.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Anorectal melanoma (AM) is an exceptionally rare malignancy.
- Limited data exist on optimal surgical management for AM.
- This study addresses the need for evidence-based treatment strategies.
Purpose of the Study:
- To retrospectively analyze treatment outcomes for anorectal melanoma.
- To compare the efficacy of different surgical approaches for AM.
Main Methods:
- Retrospective review of 19 patients with AM undergoing surgical resection.
- Analysis of clinicopathological factors and surgical methods (abdominoperineal resection vs. wide local excision).
Main Results:
- Abdominoperineal resection (APR) was associated with significantly longer overall survival (64.1 months) compared to wide local excision (WE) (10.9 months).
- No patients undergoing WE survived beyond 13 months.
- S-100 and HMB-45 immunohistochemical markers were positive in all cases, aiding diagnosis.
Conclusions:
- A high index of suspicion is vital for diagnosing AM in patients with anal symptoms.
- S-100 and HMB-45 are valuable diagnostic markers for AM.
- Data suggest APR may be a superior surgical option for improving survival in AM patients.
