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Anorectal malignant melanoma has a poor prognosis
P M Antoniuk1, J J Tjandra, B W Webb
1Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio.
International Journal of Colorectal Disease
|July 1, 1993
Summary
Primary anorectal malignant melanoma is rare, affecting older women. Surgical treatments like abdominoperineal resection (APR) and local excision (LE) showed similar recurrence and survival rates, with no long-term survivors observed.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Dermatology
Background:
- Primary anorectal malignant melanoma is a rare and aggressive malignancy.
- This study retrospectively analyzes clinicopathologic features and surgical outcomes.
Purpose of the Study:
- To investigate the clinicopathologic characteristics of primary anorectal malignant melanoma.
- To evaluate the efficacy of different surgical treatments, including abdominoperineal resection (APR) and local excision (LE).
Main Methods:
- Retrospective review of 15 patients with primary anorectal malignant melanoma.
- Analysis of clinicopathologic features, tumor characteristics, and surgical treatment outcomes.
- Endoluminal ultrasound used to assess tumor invasion depth.
Main Results:
- Female predominance (2:1) and median age of 66 years.
- Rectal bleeding and anal pain were common initial symptoms; 25% were amelanotic.
- Tumor invasion varied, with endoluminal ultrasound showing accurate depth assessment in 3/3 patients.
- Similar loco-regional recurrence rates (APR 2/4, LE 5/8) and mean survival between APR (25 mo) and LE (20 mo).
- No long-term survivors, but 4 patients remained tumor-free up to 19 months post-surgery.
Conclusions:
- Primary anorectal malignant melanoma has a poor prognosis, with similar outcomes for APR and LE.
- Early distant metastasis is common following loco-regional recurrence.
- Further research is needed to improve long-term survival rates for this rare cancer.