Anorectal melanoma

Abstract

Anorectal melanoma is an aggressive mucosal melanoma subtype with a poor prognosis. Although recent advancements have been seen for cutaneous melanoma, the optimal treatment paradigm for management of anorectal melanoma is evolving. In this review, we highlight differences in the pathogenesis of mucosal versus cutaneous melanoma, new concepts of staging for mucosal melanoma, updates to surgical management of anorectal melanoma, and current data for adjuvant radiation and systemic therapy in this unique patient population.

Management of primary anorectal mucosal melanoma during the COVID-19 pandemic

“…It has an unfavourable prognosis due to difficult diagnosis, rarity, and malignancy. Currently, the median cause-specific survival rate is very poor compared to cutaneous melanoma: 33, 18 and 6 months for localised, regional, and distant disease, respectively [ 1 – 11 ].…”

“…Furthermore, the staging, management and treatment of MAM remain a challenge because clinical outcomes do not match the extent of the disease at diagnosis in the same way as cutaneous melanoma [ 8 , 11 ]. This may be because mucosal melanomas tend to have different genetic profiles and mutations than cutaneous melanomas.…”

“…For example, BRAF-activating mutations are less common in mucosal melanoma than in cutaneous melanoma, while other mutations, such as KRAS and cKIT, appear to be more common, making the latter two important in the pathogenesis and targeted treatment of MAM [ 13 , 14 ]. Therefore, it is necessary to develop a separate staging system, which is complicated by the rarity of cases [ 11 ]. Despite this, staging systems have been proposed for mucosal melanoma, but without distinction with respect to the location of the primary tumour [ 4 , 11 , 15 ].…”

“…Therefore, it is necessary to develop a separate staging system, which is complicated by the rarity of cases [ 11 ]. Despite this, staging systems have been proposed for mucosal melanoma, but without distinction with respect to the location of the primary tumour [ 4 , 11 , 15 ].…”

“…Treatment of MAM usually involves surgery. However, there is less evidence on whether the type of surgery and adjuvant treatment, such as targeted therapy, chemotherapy, immunotherapy or radiotherapy (RT) relate to improved overall survival [ 5 , 11 , 16 – 19 ].…”