Anorectal melanoma: a large clinicopathologic study from India.
Anorectal melanoma is a rare tumor. It has dismal prognosis; only 10% of patients live longer than 5 years. It commonly presents as bleeding from the rectum or as a hemorrhoidal mass. The management of this tumor is controversial. Some authors believe that a palliative local excision is the treatment of choice, whereas others recommend radical surgery in localized disease. We present a retrospective analysis of 72 patients who were managed at our center between 1990 and 2001. This is the largest series from India. Most patients (48/72; 66%) presented with distant metastases. Twenty-four patients (24/72; 33%) underwent an abdomino-perineal resection. Nineteen patients (19/24) had positive lymph node disease, and the mean disease-free survival in these patients was 10.3 months. Disease-free survival in the node-negative patients was 26.5 months. A subset of patients with localized disease can benefit from radical surgery. In patients with large bulky localized disease, radical surgery provides better palliation than local excision.
Gastrointestinal Service, Department of Surgical Oncology, Tata Memorial Hospital, Santacruz-W, Mumbai, India.
Ganesh
G
Das
Samir
S
Gupta
P J
PJ
Shukla
P
P
Jagannath
D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007194:India; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies