Defining the role of surgery for primary gastrointestinal tract melanoma.
OBJECTIVE
The objective of the study was to determine the outcomes for primary gastrointestinal melanomas (PGIM).


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.


CONCLUSIONS
PGIM occurs most often in the oral-nasopharynx and anal canal. Surgical extirpation is the only identifiable treatment modality that significantly improves survival.
Cheung
Michael C
MC
Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Perez
Eduardo A
EA
Molina
Manuel A
MA
Jin
Xiaoling
X
Gutierrez
Juan C
JC
Franceschi
Dido
D
Livingstone
Alan S
AS
Koniaris
Leonidas G
LG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged