Anorectal Malignant Melanoma—Defining the Optimal Surgical Treatment and Prognostic Factors

Nusrath, Syed; Thammineedi, Subramanyeshwar Rao; Patnaik, Sujit Chyau; Raju, K. V. V. N.; Pawar, Sagar; Goel, Vipin; Chavali, Ramachandra Nagaraju; Murthy, Sudha

doi:10.1007/s13193-018-0791-1

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…Likewise, in our study, mitotic index and lymph node metastasis may be risk factors of prognostic signi cance. Previous study also found the presence of lymph nodes at the initial presentation profoundly affected survival [18].…”

Section: Discussionmentioning

confidence: 77%

Genetic Alteration of Chinese Patient With Rectal Mucosal Melanoma

Yang

Lai

et al. 2021

Preprint

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BACKGROUNDRectal mucosal melanoma (RMM) is an aggressive disease with a poor prognosis. Due to the rarity of RMM, few studies about genetic mechanism of the malignant tumor have been conducted. This retrospective study aimed to analyze the mutation spectrum of RMM in China and lay a foundation for targeted therapy.METHODSNext-generation sequencing was performed in 36 patients with primary RMM in Peking University Cancer Hospital from May 2010 to March 2019. TMB estimates were determined applying the TruSight Oncology 500 targeted sequencing panel. Survival analysis was performed with Kaplan-Meier, log-rank test.RESULTSNRG1 deletions, BRAF mutations and mitotic index were significant prognostic factors in the univariate analysis. In multivariable analysis in overall survival of the prognostic factors in primary RMM patients, it revealed 2 significant variables: NRG1 deletions [HR = 8.830 (95%CI: 1.026–76.026), P = 0.047)]and BRAF mutations [HR = 7.877 (95%CI: 1.158–53.603), P = 0.035].CONCLUSIONSThis is the first study to show genetic alterations exclusively to Chinese patients with RMM. Although the sample size of the current study is relatively small, we confirmed genetic mutations of RMM differs from cutaneous melanoma. Our study indicates that BRAF and NRG1 may be potential therapeutic targets for rectal mucosal melanoma treatment. AKT3/KCNH1 fusion was correlated with a poor prognostic of RMM.

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Section: Discussionmentioning

confidence: 77%

Genetic Alteration of Chinese Patient With Rectal Mucosal Melanoma

Yang

Lai

et al. 2021

Preprint

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“…On multivariate analysis, younger age, urban location of the patients and surgery were associated with better OS [52]. Other studies have found that age, tumor thickness, presence of ulceration, lymphovascular invasion, perineural invasion and tumor AJCC stage are the main predictors of survival [15,39,40].…”

Section: Prognostic Factorsmentioning

confidence: 90%

“…The reported 1-,2-,3-,4-OS rates have been 67,40,40 and 32% in APR group and 100,100,67, and 67% in WLE group [39]. The median survival in WLE and APR groups were 36 and 13 months respectively [3].…”

Section: Prognostic Factorsmentioning

confidence: 98%

“…There is no formal staging system for AM. However, the most commonly described system for AM in previous studies is the Ballantye clinical system which has three stages as follows: Stage I -localized disease, Stage II -presence of inguinal or pelvic lymph nodes and stage III -distant metastasis [37][38][39]. Interestingly, a recent study by Nagarajan et al involving 160 AM patients found that the clinical American Joint Cancer Committee (AJCC) staging system (8th edition) for CM significantly stratified disease-specific survival of AM patients.…”

Section: Diagnosis and Stagingmentioning

confidence: 99%

“…So, we believe that WLE with regular surveillance should be the preferred approach. If WLE is not feasible or there is local recurrence without distant metastasis, then APR should be considered [39].…”

Section: Surgerymentioning

confidence: 99%

See 2 more Smart Citations

Anorectal Melanoma

Gupta¹,

Bansal²,

Ammar³

et al. 2021

Melanoma

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Malignant melanoma is an aggressive disease. The anorectal region is the most common site of primary gastrointestinal malignant melanoma. Due to its low incidence, the diagnosis is often delayed. The most characteristic clinical feature of this tumor is its brown-black appearance due to the melanin pigment. However, the pigmentation may be absent in up to 20% cases. Timely diagnosis and treatment are crucial for achieving good long-term outcomes. Surgical excision remains the treatment of choice for localized disease. However, the extent of surgery has been a matter of debate. Anorectal melanoma is a highly malignant disease, and more than 50% cases have metastasis at the time of diagnosis. Targeted therapies especially immune check point inhibitors have brought about a paradigm shift in the management of cutaneous melanoma. They are being increasingly used for mucosal melanomas, and their role in anorectal melanoma is being investigated in various clinical trials.

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Anal Cancer

Sands

Mahmoud

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Tumors of the anal region are divided into anal and perianal cancers with different paths of lymphatic drainage.• Squamous cell carcinoma (SCC) is the most common type of anal cancer. • Chemoradiotherapy is the mainstay for anal (SCCa). The standard chemotherapy consists of 5-FU and mitomycin. The minimum dose of radiation is 45 Gy to the primary tumor. • Inguinal node metastasis can be diagnosed with PET-CT and managed with radiation. • Surgery for anal canal cancer is limited to very small lesions and salvage situations following failed chemoradiotherapy. • Anal adenocarcinoma can arise from an anal gland or chronic fistula tract. They can be difficult to distinguish from distal rectal cancers. These tumors are staged and treated similar to rectal cancers with a lower overall survival. • Verrucous carcinomas are characterized by large size and lack of invasion. Treatment is mainly wide surgical excision. • Anal melanoma is a rare and aggressive tumor. Survival is very poor. Abdominoperineal resection may help to control local disease but does not prolong life expectancy; therefore, local excision is often a first choice when possible. • Perianal Paget's disease -or intraepithelial adenocarcinoma -is frequently associated with other malignancies.Treatment is focused on surgical excision and may require mapping biopsies to plan resection.• Basal cell carcinoma of the perianal region is treated with wide local excision. • Gastrointestinal stromal tumors can be managed with wide local excision or radical excision depending on margin status. Preoperative treatment with tyrosine kinase inhibitors may enhance resectability.

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Anorectal Malignant Melanoma—Defining the Optimal Surgical Treatment and Prognostic Factors

Cited by 11 publications

References 10 publications

Genetic Alteration of Chinese Patient With Rectal Mucosal Melanoma

Genetic Alteration of Chinese Patient With Rectal Mucosal Melanoma

Anorectal Melanoma

Anal Cancer

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