Skip to main content
SpringerLink
Log in

Defining the Role of Surgery for Primary Gastrointestinal Tract Melanoma

  • original article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

The objective of the study was to determine the outcomes for primary gastrointestinal melanomas (PGIM).

Material and methods

The Surveillance, Epidemiology, and End Results database (1973–2004) was queried.

Results

Overall, 659 cases of PGIM were identified. The annual incidence of PGIM was approximately 0.47 cases per million in 2000. Overall median survival time was 17 months. Tumors were identified in the oral–nasopharynx (32.8%), anal canal (31.4%), rectum (22.2%), esophagus (5.9%), stomach (2.7%), small bowel (2.3%), gallbladder (1.4%), and large bowel (0.9%). Univariate analysis demonstrated age, tumor location, stage, surgery, and lymph node status were significant predictors of improved survival. MST has not been reached for tumors located in the large bowel, while tumors located in the stomach demonstrated the shortest median survival (5 months). Improvement in MST was observed for those patients undergoing surgical resection. The presence of lymph node involvement conferred a poorer prognosis. Multivariate analysis of the cohort identified that location, advanced tumor stage, failure to undertake surgical resection, positive lymph node status, and age were all independent predictors of poorer outcome.

Conclusion

PGIM occurs most often in the oral–nasopharynx and anal canal. Surgical extirpation is the only identifiable treatment modality that significantly improves survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001;19(16):3635–3648.

    PubMed  CAS  Google Scholar 

  2. Balch CM, Soong SJ, Gershenwald JE, et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001;19(16):3622–3634.

    PubMed  CAS  Google Scholar 

  3. Clemmensen OJ, Fenger C. Melanocytes in the anal canal epithelium. Histopathology 1991;18(3):237–241.

    Article  PubMed  CAS  Google Scholar 

  4. De La Pava S. NG, Pickren JW, Cabrera A. Melanosis of the esophagus. Cancer 1963;16:48–50.

    Article  Google Scholar 

  5. Stranks GJ, Mathai JT, Rowe-Jones DC. Primary malignant melanoma of the oesophagus: case report and review of surgical pathology. Gut 1991;32(7):828–830.

    Article  PubMed  CAS  Google Scholar 

  6. Joob AW, Haines GK 3rd, Kies MS, Shields TW. Primary malignant melanoma of the esophagus. Ann Thorac Surg 1995;60(1):217–222.

    PubMed  CAS  Google Scholar 

  7. Elsayed AM, Albahra M, Nzeako UC, Sobin LH. Malignant melanomas in the small intestine: a study of 103 patients. Am J Gastroenterol 1996;91(5):1001–1006.

    PubMed  CAS  Google Scholar 

  8. Woollons A, Derrick EK, Price ML, Darley CR. Gastrointestinal malignant melanoma. Int J Dermatol 1997;36(2):129–131.

    Article  PubMed  CAS  Google Scholar 

  9. Patel JK, Didolkar MS, Pickren JW, Moore RH. Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg 1978;135(6):807–810.

    Article  PubMed  CAS  Google Scholar 

  10. De Simone P, Gelin M, El Nakadi I. Amelanotic malignant melanoma of the esophagus. Report of a case. Minerva Chir 2006;61(1):45–49.

    PubMed  Google Scholar 

  11. Sanyal S, Kaman L, Behera A, Kakkar N. Primary small bowel melanoma: a case report. Trop Gastroenterol 2004;25(4):187–188.

    PubMed  Google Scholar 

  12. Kruger S, Noack F, Blochle C, Feller AC. Primary malignant melanoma of the small bowel: a case report and review of the literature. Tumori 2005;91(1):73–76.

    PubMed  Google Scholar 

  13. Avital S, Romaguera RL, Sands L, et al. Primary malignant melanoma of the right colon. Am Surg 2004;70(7):649–651.

    PubMed  Google Scholar 

  14. Atmatzidis KS, Pavlidis TE, Papaziogas BT, Papaziogas TB. Primary malignant melanoma of the small intestine: report of a case. Surg Today 2002;32(9):831–833.

    Article  PubMed  Google Scholar 

  15. Poggi SH, Madison JF, Hwu WJ, et al. Colonic melanoma, primary or regressed primary. J Clin Gastroenterol 2000;30(4):441–444.

    Article  PubMed  CAS  Google Scholar 

  16. Rao GM, Satyanarayana Y, Janaki M, Hayath MS. Primary melanocarcinoma of stomach. Indian J Gastroenterol 1999;18(4):176.

    PubMed  CAS  Google Scholar 

  17. Kadivar TF, Vanek VW, Krishnan EU. Primary malignant melanoma of the small bowel: a case study. Am Surg 1992;58(7):418–422.

    PubMed  CAS  Google Scholar 

  18. Chalkiadakis G, Wihlm JM, Morand G, et al. Primary malignant melanoma of the esophagus. Ann Thorac Surg 1985;39(5):472–475.

    Article  PubMed  CAS  Google Scholar 

  19. Volpin E, Sauvanet A, Couvelard A, Belghiti J. Primary malignant melanoma of the esophagus: a case report and review of the literature. Dis Esophagus 2002;15(3):244–249.

    Article  PubMed  CAS  Google Scholar 

  20. Fritz A. International classification of diseases for oncology: ICD-O. 3rd ed. Geneva: World Health Organization; 2000.

    Google Scholar 

  21. National Cancer Institute. Surveillance, Epidemiology and End Results (SEER) Program, 2005.

  22. Gutierrez JC, Fischer AC, Sola JE, et al. Markedly improving survival of neuroblastoma: a 30-year analysis of 1,646 patients. Pediatr Surg Int 2007;23(7):637–646.

    Article  PubMed  Google Scholar 

  23. Gutierrez JC, Franceschi D, Koniaris LG. How many lymph nodes properly stage a periampullary malignancy? J Gastrointest Surg 2007 Aug 15 (in press) PMID: 17701264.

  24. Gutierrez JC, Perez EA, Moffat FL, et al. Should soft tissue sarcomas be treated at high-volume centers? An analysis of 4205 patients. Ann Surg 2007;245(6):952–958.

    Article  PubMed  Google Scholar 

  25. Hodgson N, Koniaris LG, Livingstone AS, Franceschi D. Gastric carcinoids: a temporal increase with proton pump introduction. Surg Endosc 2005;19(12):1610–1612.

    Article  PubMed  CAS  Google Scholar 

  26. Perez EA, Gutierrez JC, Jin X, et al. Surgical outcomes of gastrointestinal sarcoma including gastrointestinal stromal tumors: a population-based examination. J Gastrointest Surg 2007;11(1):114–125.

    Article  PubMed  Google Scholar 

  27. Perez EA, Koniaris LG, Snell SE, et al. 7201 carcinoids: increasing incidence overall and disproportionate mortality in the elderly. World J Surg 2007;31(5):1022–1030.

    Article  PubMed  Google Scholar 

  28. Perez EA, Livingstone AS, Franceschi D, et al. Current incidence and outcomes of gastrointestinal mesenchymal tumors including gastrointestinal stromal tumors. J Am Coll Surg 2006;202(4):623–629.

    Article  PubMed  Google Scholar 

  29. Dasgupta TK, Brasfield RD. Metastatic Melanoma of the Gastrointestinal Tract. Arch Surg 1964;88:969–973.

    PubMed  CAS  Google Scholar 

  30. Blecker D, Abraham S, Furth EE, Kochman ML. Melanoma in the gastrointestinal tract. Am J Gastroenterol 1999;94(12):3427–3433.

    Article  PubMed  CAS  Google Scholar 

  31. Ironside JW, Timperley WR, Madden JW, et al. Primary melanoma of the urinary bladder presenting with intracerebral metastases. Br J Urol 1985;57(5):593–594.

    Article  PubMed  CAS  Google Scholar 

  32. Kim CJ, Reintgen DS, Balch CM. The new melanoma staging system. Cancer Control 2002;9(1):9–15.

    PubMed  Google Scholar 

  33. Tessier DJ, McConnell EJ, Young-Fadok T, Wolff BG. Melanoma metastatic to the colon: case series and review of the literature with outcome analysis. Dis Colon Rectum 2003;46(4):441–447.

    Article  PubMed  Google Scholar 

  34. White RR, Stanley WE, Johnson JL, et al. Long-term survival in 2,505 patients with melanoma with regional lymph node metastasis. Ann Surg 2002;235(6):879–887.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Michael C. Cheung, Eduardo A. Perez, Manuel A. Molina, Xiaoling Jin, Juan C. Gutierrez, Dido Franceschi, Alan S. Livingstone & Leonidas G. Koniaris

  2. Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Suite 3550, 1475 NW 12th Ave., Miami, FL, 33136, USA

    Leonidas G. Koniaris

Authors
  1. Michael C. Cheung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eduardo A. Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manuel A. Molina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaoling Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Juan C. Gutierrez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dido Franceschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alan S. Livingstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Leonidas G. Koniaris
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leonidas G. Koniaris.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cheung, M.C., Perez, E.A., Molina, M.A. et al. Defining the Role of Surgery for Primary Gastrointestinal Tract Melanoma. J Gastrointest Surg 12, 731–738 (2008). https://doi.org/10.1007/s11605-007-0417-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-007-0417-3

Keywords

Search

Navigation