Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 28, 2011; 17(4): 534-539
Published online Jan 28, 2011. doi: 10.3748/wjg.v17.i4.534
Anorectal malignant melanomas: Retrospective experience with surgical management
Xu Che, Dong-Bing Zhao, Yong-Kai Wu, Cheng-Feng Wang, Jian-Qiang Cai, Yong-Fu Shao, Ping Zhao
Xu Che, Dong-Bing Zhao, Yong-Kai Wu, Cheng-Feng Wang, Jian-Qiang Cai, Yong-Fu Shao, Ping Zhao, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Che X, Zhao DB, Wang CF, Shao YF, Cai JQ and Zhao P contributed equally to this work; Zhao DB, Shao YF, Wang CF and Cai JQ performed the research; Che X, Wu YK and Zhao DB analyzed the data; Che X and Zhao DB wrote the paper.
Correspondence to: Dong-Bing Zhao, MD, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. dbzhao2003@sina.com
Telephone: +86-10-87788521 Fax: +86-10-67730386
Received: March 14, 2010
Revised: July 20, 2010
Accepted: July 27, 2010
Published online: January 28, 2011
Abstract

AIM: To present the experience and outcomes of the surgical treatment for the patients with anorectal melanoma from the Cancer Hospital, Chinese Academy of Medical Sciences.

METHODS: Medical records of the diagnosis, surgery, and follow-up of 56 patients with anorectal melanoma who underwent surgery between 1975 and 2008 were retrospectively reviewed. The factors predictive for the survival rate of these patients were identified using multivariate analysis.

RESULTS: The 5-year survival rate of the 56 patients with anorectal melanoma was 20%, 36 patients underwent abdominoperineal resection (APR) and 20 patients underwent wide local excision (WLE). The rates of local recurrence of the APR and WLE groups were 16.13% (5/36) and 68.75% (13/20), (P = 0.001), and the median survival time was 22 mo and 21 mo, respectively (P = 0.481). Univariate survival analysis demonstrated that the number of tumor and the depth of invasion had significant effects on the survival (P < 0.05). Multivariate analysis showed that the number of tumor [P = 0.017, 95% confidence interval (CI) = 1.273-11.075] and the depth of invasion (P = 0.015, 95% CI = 1.249-7.591) were independent prognostic factors influencing the survival rate.

CONCLUSION: Complete or R0 resection is the first choice of treatment for anorectal melanoma, prognosis is poor regardless of surgical approach, and early diagnosis is the key to improved survival rate for patients with anorectal melanoma.

Keywords: Anorectal melanomas; Prognostic factors; Surgical management; Survival rate