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Indian Journal of Surgical Oncology

, Volume 9, Issue 4, pp 519–523 | Cite as

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

  • Syed NusrathEmail author
  • Subramanyeshwar Rao Thammineedi
  • Sujit Chyau Patnaik
  • K. V. V. N. Raju
  • Satish Pawar
  • Vipin Goel
  • Ramachandra Nagaraju Chavali
  • Sudha Murthy
Original Article

Abstract

Patients with anorectal malignant melanoma (ARMM) have a poor prognosis. Optimal surgical treatment is not defined. The aim of the study was to define the surgical treatment for ARMM, to compare the overall survival (OS) of abdomino-perineal resection (APR) and wide local excision (WLE) and to study various prognostic factors. Thirty patients of ARMM were managed, 20 with locoregional disease, 10 metastatic. Of the 20 patients with locoregional disease, 15 underwent APR and 5 WLE. The 1-, 2-, 3-, and 4-year overall survival rates (by Kaplan–Meier survival analysis) in the APR group were 67, 40, 40, and 32%, and in WLE group were 100, 100, 67, and 67% respectively. Median survival for APR and WLE groups were 13 and 36 months and were not significant (p 0.48). Node-negative patients had better survival than node positive in the APR group (56 vs. 13 months) (p 0.017). Patients with tumor size < 2cm, lymphovascular invasion and perineural invasion negative, and margin-negative and with superficial infiltration had a trend toward better survival than their counterparts. WLE gives an equivalent oncological outcome and can be offered for patients with smaller ARMM and APR for locally advanced, larger tumors or as a salvage following recurrence after WLE.

Keywords

Anorectal malignant melanoma Abdomino-perineal resection Wide local excision Survival 

Abbreviations

ARMM

anorectal malignant melanoma

OS

overall survival

APR

abdomino-perineal resection

WLE

wide local excision

LVI

lymphovascular invasion

PNI

perineural invasion

Notes

Compliance with Ethical Standards

This study was approved by ethics committee of Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  • Syed Nusrath
    • 1
    Email author
  • Subramanyeshwar Rao Thammineedi
    • 1
  • Sujit Chyau Patnaik
    • 1
  • K. V. V. N. Raju
    • 1
  • Satish Pawar
    • 1
  • Vipin Goel
    • 1
  • Ramachandra Nagaraju Chavali
    • 1
  • Sudha Murthy
    • 2
  1. 1.Department of Surgical OncologyBasavatarakam Indo American Cancer Hospital and Research InstituteHyderabadIndia
  2. 2.Department of Laboratory MedicineBasavatarakam Indo American Cancer Hospital and Research InstituteHyderabadIndia

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