Patterns of Failure in Anorectal Melanoma

Ross, Merrick I.; Pezzi, Christopher M.; Pezzi, Thomas A.; Meurer, Dennis; Hickey, Robert C.; Balch, Charles M.

doi:10.1001/archsurg.1990.01410150035007

Cited by 158 publications

(121 citation statements)

References 15 publications

Supporting

Mentioning

117

Contrasting

Unclassified

Order By: Relevance

“…It should be noted, however, that in most studies it is difficult to compare patient's prognostic factors due to the fact that insufficient information is provided. Nevertheless, there was a trend that local disease is more effectively controlled by APR than WLE (Abbas et al, 1980;Ross et al, 1990;Roumen, 1996;Thibault et al, 1997). To this end, Thibault reported that isolated local recurrences after APR were rare (Thibault et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Anorectal melanoma: surgical management guidelines according to tumour thickness

et al. 2003

View full text Add to dashboard Cite

Management of patients with anorectal melanoma is still controversial. To reach a rationale therapeutic approach, we reviewed our experience obtained over the past decade. In all, 19 consecutive patients with the diagnosis of anorectal melanoma were included in this retrospective survey. Details of the patients' presentation, symptoms, tumour size and histology and tumour state were recorded, and the primary therapeutic procedures were evaluated in detail. The size of the tumours ranged between 0.5 and 7 cm in diameter. The median tumour thickness was 10 mm (range 0.6 -40 mm). At diagnosis, six of 19 patients already presented with either regional or distant metastases. The remaining 13 patients were treated with curative intend, either by abdomino-perineal resection (APR) or wide local excision (WLE). The form of operative therapy, however, had no impact on overall survival. Nevertheless, the incidence of local recurrences was lower after APR even for patients with less favourable tumours. In conclusion, WLE alone is not sufficient for local tumour control of thick anorectal melanoma.

show abstract

Section: Discussionmentioning

confidence: 99%

Anorectal melanoma: surgical management guidelines according to tumour thickness

et al. 2003

View full text Add to dashboard Cite

show abstract

“…[4,7] Treatment was based on the extent of disease at presentation. Patients with stage III or stage II disease were advised only supportive care.…”

Section: Original Articlementioning

confidence: 99%

“…[3] The five-year overall survival in patients with anorectal melanoma ranges from 4 to 31%, while the median survival varies from 16 to 28 months. [4][5][6][7][8][9][10][11] There are no definite recommendations for the management of these lesions. Treatment strategies have varied from the radical abdominoperineal resection (APR) to the conservative wide local excision (WLE).…”

Section: Introductionmentioning

confidence: 99%

Optimizing local control in anorectal melanoma

Mahajan

Kannan

2008

Indian J Cancer

View full text Add to dashboard Cite

13of anorectal melanoma were evaluated in our institution. These patients were identified from the computer data base in our tumor registry using the ICD-O (third edition) site codes for anus and rectum (C21.0, C44.5 and C20.9) and the morphology code for melanoma (M-8720/3). The case records of these patients were retrospectively reviewed in detail to obtain information regarding clinical features (symptoms, duration, investigations and stage), pathological features (size, depth of invasion and immunohistochemical studies), treatment and follow-up details. Depth of the lesion was assessed either by histopathological examination of the surgical specimen or by clinical examination in patients who did not undergo surgery.Immunohistochemistry (IHC), performed by the streptavidin-biotin-peroxidase method was used to further categorize anorectal tumors labelled on routine Optimizing local control in anorectal melanomaRamakrishnan AS, Mahajan V, Kannan R Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai -600 036, Tamil Nadu, IndiaCorrespondence to: Dr. Ramakrishnan AS, E-mail: ram_a_s@yahoo.com Abstract BACKGROUND: Wide local excision (WLE) of anorectal melanoma is associated with a high incidence of local recurrence.

show abstract

“…Ross et al reviewed 32 patients with melanoma treated with either APR or local resection and concluded that local recurrence was lower in the APR group compared to local excision (29% vs 58%), however there was no difference in overall survival (19.5 months vs 18.9 months) [27]. Retrospective studies also confirmed comparable overall survival between APR and local excision [29,30].…”

Section: Treatmentmentioning

confidence: 99%

“…Regional lymph nodes are involved in 60% of patients at presentation, and distant metastases are present in 30% [27,28]. Other rare sites have also been reported for primary mucosal melanoma.…”

Section: Anorectal Malignant Melanoma Presentationmentioning

confidence: 99%

Primary Mucosal Melanoma: Uncommonly Described Entity

Yadav¹,

Jatal²

2015

Surgery

View full text Add to dashboard Cite

BackgroundMalignant melanoma arises by malignant transformation of the normal melanocytes. Distribution of malignant melanoma includes cutaneous (91.2%), ocular (5.3%), mucosal (1.3%), and unknown primary site (2.2%) [1]. Because of rarity and clinical challenges arising from different anatomic location, our understanding for the optimal management of mucosal melanoma remains limited. Malignant melanoma can arise from the mucosal epithelium of respiratory, alimentary, and genitourinary tracts, all of which contain melanocytes. The most common sites for primary mucosal melanoma include head and neck followed by anorectal, and vulvovaginal regions (55, 24, and 18%, respectively). Rarer sites are urinary tract, gallbladder, and small intestine.Although melanocytes share same embryologic origin, mucosal melanomas behave more aggressively and have many different characteristics compared to cutaneous melanomas. Mucosal melanomas are multifocal in 20% cases, while cutaneous melanomas are multifocal in 5% [2,3]. 40% of mucosal melanomas are amelanotic, while <10% of cutaneous melanomas [3]. In the following section we described this uncommonly presented entity. 5 year survival for mucosal melanoma is 25%, while that for cutaneous melanoma it is 80.8% [1]. EtiopathogenesisMucosal melanoma arises in non-sun exposed parts of the body and risk factors are not properly defined. Incidence increases with age and > 65% of patients are older than 60 years [4]. The difference between white and black population is less pronounced compared to cutaneous melanoma and mucosal melanomas are approximately twice higher among whites compared to blacks [5]. The higher incidence in females compared to males is because of the predominance of genital tract melanomas in females, which account for 56.5% of mucosal melanomas among them [5]. There is no difference in rates between genders for extragenital mucosal melanomas.For oral mucosal melanoma cigarette smoking has been suggested as a risk factor [6]. Formaldehyde has been implicated in sinonasal mucosal melanoma [7]. Genetic studies identified increased prevalence of c-KIT mutation and lower expression BRAF and NRAS oncogene mutation in mucosal melanoma compared with cutaneous melanoma [8,9]. Diagnosis and StagingWhole body skin examination and ophthalmic examination are important to exclude possibility of metastatic lesion from primary cutaneous or ocular melanoma and it is more important when diagnosing melanoma in sites, where it occurs uncommonly. To distinguish primary lesions from metastases Allen and Spitz identified junctional or in situ melanoma component with intact epithelium overlaying invasive melanoma as main diagnostic criteria for primary melanoma [10]. As diagnosis of mucosal melanomas is usually delayed and many lesions are ulcerated, this criterion is not easy to assess.There is no uniformly accepted staging system for mucosal melanoma and varies depending on the primary site. A simplified staging system originally developed for head and neck melanoma can be applied to al...

show abstract

Patterns of Failure in Anorectal Melanoma

Cited by 158 publications

References 15 publications

Anorectal melanoma: surgical management guidelines according to tumour thickness

Anorectal melanoma: surgical management guidelines according to tumour thickness

Optimizing local control in anorectal melanoma

Primary Mucosal Melanoma: Uncommonly Described Entity

Contact Info

Product

Resources

About