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Anorectal melanoma--an incurable disease?
C Thibault1, P Sagar, S Nivatvongs
1Division of Colon and Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Diseases of the Colon and Rectum
|June 1, 1997
Summary
Anorectal melanoma has a poor prognosis, with low survival rates regardless of surgical approach. No factors predicted recurrence in this study of 50 patients.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Anorectal melanoma is a rare and aggressive malignancy.
- Limited data exists on recurrence and survival following surgical intervention.
Purpose of the Study:
- To describe recurrence and survival rates for anorectal melanoma after operative treatment.
- To identify potential predictive factors for recurrence.
Main Methods:
- Retrospective review of 50 patient records with anorectal melanoma.
- Data collected between 1939 and 1993.
Main Results:
- Overall five-year survival was 22% and disease-free survival was 16%.
- Metastatic disease at diagnosis led to death within 12 months.
- Abdominoperineal resection (APR) and wide local excision showed similar survival and recurrence rates.
- No patient or tumor characteristics predicted recurrence.
Conclusions:
- Prognosis for anorectal melanoma remains poor, irrespective of surgical treatment.
- Wide local excision with a 1 cm negative margin is recommended.
- APR is reserved for unresectable tumors or palliative care.