title: Surgical treatment for anorectal malignant melanoma: report of five cases and review of 79 Japanese cases.
abstract: BACKGROUND
  Anorectal malignant melanoma (AMM) is a relatively rare disease. Because of its poor prognosis, the optimal surgical treatment for AMM is still controversial and difficult to determine. In this paper, we report five cases of AMM that have been treated by surgery and/or other methods at Shinshu University Hospital within the last decade. We also review the present five cases along with 74 other Japanese cases reported between 1997 and 2006 and discuss the role of surgery in the treatment of AMM.
  
  
  CONCLUSIONS
  Among our AMM patients, two who underwent radical abdominoperineal resection had long survival, while the other three patients who underwent palliative surgery had a poor outcome. On the total of 79 AMM patients, those who underwent curative surgery had a better outcome than those who underwent palliative surgery (p < 0.0001). Furthermore, the outcome of AMM patients at stages 0 and I was better than that of AMM patients at stages II, III, and IV (p < 0.0001). There was no significant difference in survival between AMM patients with and without adjuvant chemotherapy.
  
  
  CONCLUSIONS
  In conclusion, AMM patients treated by curative surgery can expect long-term survival, although the usefulness of adjuvant chemotherapy for AMM patients is controversial.
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishizone
authors.forename: Naohiko
authors.initials: N
authors.lastname: Koide
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Karasawa
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Akita
authors.forename: Futoshi
authors.initials: F
authors.lastname: Muranaka
authors.forename: Hisashi
authors.initials: H
authors.lastname: Uhara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D001005:Anus Neoplasms / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D010166:Palliative Care; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D016896:Treatment Outcome