title: Treatment outcomes of anorectal melanoma.
abstract: OBJECTIVE
  An anorectal melanoma (AM) is a very rare tumor. However, sufficient data supporting effective surgical options for the disease do not exist. This retrospective review aimed to analyze treatment outcomes for an AM.
  
  
  METHODS
  From June 1999 to December 2008, we retrospectively reviewed a prospectively collected consecutive series of 19 patients who had undergone a surgical resection for an AM at a single institute. Surgical method and clinicopathological factors were analyzed.
  
  
  RESULTS
  The median age was 61.4 years (range, 46 to79 years). Main symptoms were an anal mass, hematochezia, perianal pain, tenesmus, fecal incontinence, and bowel habit change. The average duration of symptoms before diagnosis was 7.8 months (range, 1 to 36 months). S-100 and HMB-45 were positive in all patients, even in non-melanin pigmentation. There were 12 abdominoperineal resections (APRs) and 7 wide local excisions (WEs). The APR showed longer overall survival when compared with the WE (64.1 months vs. 10.9 months, P < 0.001). No patients who underwent a WE survived more than 13 months.
  
  
  CONCLUSIONS
  A high index of suspicion is necessary to establish the diagnosis for an AM in patients with anal symptoms, and S-100 and HMB-45 can be useful markers for an AM. Even with the small number of cases and the short follow-up, our data suggest that an APR for an AM may provide longer survival than a WE.
authors: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Byung Min
authors: BM
authors: Choi
authors: Hyoung Ran
authors: HR
authors: Kim
authors: Hae-Ran
authors: HR
authors: Yun
authors: Seung Ho
authors: SH
authors: Choi
authors: Yong Beom
authors: YB
authors: Cho
authors: Hee Cheol
authors: HC
authors: Kim
authors: Seong Hyeon
authors: SH
authors: Yun
authors: Woo Yong
authors: WY
authors: Lee
authors: Ho-Kyung
authors: HK
authors: Chun