[Primary anorectal melanoma. Apropos of 19 cases].
OBJECTIVE
The aim of this study was to determine the significant prognostic factors for primary anorectal melanoma and propose a standard surgical procedure.


METHODS
From 1975 to 1995, 19 patients with primary melanoma of the anus were treated. Five patients were given palliative care, 6 had abdominoperineal amputation and 8 had curative local transrectal tumoral excision. Two patients also underwent inguinal node dissection.


RESULTS
Overall 5-year survival was 21%. Univariate analysis showed a significantly poorer prognosis when: inguinal or pelvic nodes were invaded (p = 0.01), surgical margins were invaded (p = 0.003), visceral metastases were present (p = 0.01) and the tumor measured over 20 mm thick (p = 0.01). Prognosis was unchanged by the type of surgical exeresis.


CONCLUSIONS
Local transrectal excision is the first ling choice for primary anorectal melanoma. Amputation of the rectum should be reserved for cases where complete tumor resection is technically impossible transrectally. Node dissection is indicated in cases with clinical invasion of the inguinal nodes.
Dubé
P
P
Département de Chirurgie, Institut Gustave-Roussy, Centre de Lutte Contre le Cancer, Villejuif.
Elias
D
D
Bonvalot
S
S
Spatz
A
A
Lasser
P
P
D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003663:Decision Trees; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010166:Palliative Care; D010385:Pelvic Exenteration; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate