Survival following surgical treatment for anorectal melanoma seems similar for local excision and extensive resection regardless of nodal involvement

• Published in: Surgical oncology 2021-06, Vol.37, p.101558-101558, Article 101558
• Main Authors: Jutten, E., Kruijff, S., Francken, A.B., van Westreenen, H.L., Wevers, K.P.
• Format: Article
• Language: English
• Subjects: Abdominoperineal resection; Aged; Anorectal; Anorectal melanoma; Anus Neoplasms - mortality; Anus Neoplasms - pathology; Anus Neoplasms - surgery; Diagnosis; Endoscopy; Female; Humans; Local excision; Lymphatic Metastasis; Lymphatic system; Male; Malignancy; Medical prognosis; Melanoma; Melanoma - mortality; Melanoma - pathology; Melanoma - surgery; Metastasis; Microsurgery; Middle Aged; Netherlands; Patients; Proctectomy; Registries; Retrospective Studies; Staging; Surgery; Surgical techniques; Survival; Survival Rate; Time-to-Treatment; Treatment Outcome; Ultrasonic imaging
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/j.suronc.2021.101558

Anorectal melanoma is a rare malignancy with a dismal prognosis. The purpose of this study was to investigate whether the survival per stage is influenced by the surgical approaches (local excision or extensive resection), to assess prognostic factors of survival, and to answer the question whether the practiced surgical approaches changed over time. Dutch cancer registry organizations (IKNL and PALGA) were queried for all patients with a diagnosis of anorectal melanoma (1989–2019). Patients with disseminated disease at diagnosis were excluded. Survival outcomes were compared for the two surgical approaches stratified by stage (clinical node negative (cN0) and clinical node positive (cN+)) and date of diagnosis. A total of 103 patients were included in this study. In both cN0 and cN+ patients the surgical strategy did not significantly influence survival (cN0: 21.7% 5-year survival, median 25 months for local excision versus 13.7% 5-year survival, median 17 months for extensive resection (p = 0.228), cN+: 11.1% 5-year survival for local excision, median 17 months versus 8.7% 5-year survival, median 14 months for extensive resection (p = 0.741)). Stage and date of diagnosis showed to be prognostic factors of survival. The ratio between the two surgical approaches was unchanged over three decades. Extensive resection does not seem to improve survival in both cN0 and cN+ anorectal melanoma patients compared to local excision. However in the past three decades no shift towards local excision has been found. cN+ stage and an older date of diagnosis are predictors for worse survival. •Extensive resection does not seem to improve survival in both cN0 and cN + anorectal melanoma.•In the past three decades no shift towards local excision.•cN + stage and an older date of diagnosis are negative predictors of survival.