Sphincter-Sparing Local Excision and Adjuvant Radiation for Anal-Rectal Melanoma

Ballo, Matthew T.; Gershenwald, Jeffrey E.; Zagars, Gunar K.; Lee, Jeffrey E.; Mansfield, Paul F.; Strom, Eric A.; Bedikian, Agop Y.; Kim, Kevin B.S.; Papadopoulos, Nicholas E.; Prieto, Víctor G.; Ross, Merrick I.

doi:10.1200/jco.2002.03.002

Cited by 141 publications

(109 citation statements)

References 12 publications

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“…Unfortunately, only for 60% of the patients the histological tumour thickness was given. Ballo et al (2002) reported that adjuvant radiation of the pelvis and inguinal lymph nodes after WLE showed similar rates of local tumour control as APR. From 23 patients with mean histological tumour thickness of 5 mm (range 0.3 -35 mm), five of them had a local and three a nodal failure, but none of these patients required an APR for palliation.…”

Section: Discussionmentioning

confidence: 95%

“…In contrast, Slingluff et al (1990) suggested that the only predictive factor for survival was stage of disease, that is, local, regional or systemic, at the time of diagnosis, whereas Ballo et al (2002) reported a favourable disease-free survival outcome when the tumour thickness was below 4 mm.…”

Section: Discussionmentioning

confidence: 97%

“…If such patients decide to have only a WLE, they should be aware that local failure is common and complications requiring additional surgery may occur. In this respect, adjuvant radiation has been suggested to hold the promise of sphincter preservation together with sufficient tumour control (Ballo et al, 2002). However, acute radiation-related dermatitis was noted by most patients and chronic radiation-related toxicity occurred in six of 23 patients.…”

Section: Discussionmentioning

confidence: 99%

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Anorectal melanoma: surgical management guidelines according to tumour thickness

et al. 2003

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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.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Anorectal melanoma: surgical management guidelines according to tumour thickness

et al. 2003

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“…The use of radiation therapy in different modalities has been described, although no one regimen has proven superior 7. The use of systemic therapy has been underwhelming, as well.…”

Section: Discussionmentioning

confidence: 99%

Anorectal melanoma treated with abdominoperineal resection

Svoboda

Attuwaybi

2018

Clinical Case Reports

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“…21 Prognostic factors include the stage of the disease at the time of diagnosis and the tumor thickness. 22,23 At present, surgery represents the mainstay of treatment, but the optimal approach is still controversial. Surgical intervention includes wide local excision (WLE) and abdomino-perineal resection (APR).…”

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confidence: 99%

Primary anorectal melanoma: a case of 5 year disease-free survival

2017

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Anorectal melanoma is a rare cause of anorectal malignancies affecting mainly elderly people without significant gender differences, although there seems to be a white predominance. Diagnosis is often challenging, since symptoms are frequently nonspecific. Radical surgery is the mainstay of treatment, while adjuvant therapies are generally of limited value. Thus, prognosis is still grim, with a 5-year survival rate of less than 20%. We report the case of a 75-year-old white female presenting with mild anal pain and blood in stools. Diagnosed with an ulcerated melanoma of the perianal area, she eventually underwent an abdominoperineal resection and bilateral inguinal lymphadenectomy. To date, she is currently alive and disease-free. Given the lack of adequate international guidelines, we recommend defining a tailored treatment by thorough multidisciplinary discussion, as well as taking into account the patient personal preference.

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Sphincter-Sparing Local Excision and Adjuvant Radiation for Anal-Rectal Melanoma

Abstract: Sphincter-sparing local excision and adjuvant radiation is well tolerated and can effectively control local-regional disease while avoiding the functional morbidity of APR.

Cited by 141 publications

References 12 publications

Anorectal melanoma: surgical management guidelines according to tumour thickness

Anorectal melanoma: surgical management guidelines according to tumour thickness

Anorectal melanoma treated with abdominoperineal resection

Primary anorectal melanoma: a case of 5 year disease-free survival

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