Treatment Strategies and Survival Trends for Anorectal Melanoma: Is it Time for a Change?
World J Surg
; 43(7): 1809-1819, 2019 07.
Article
en En
| MEDLINE
| ID: mdl-30830243
ABSTRACT
BACKGROUND:
Immunotherapy advances for the treatment of cutaneous melanoma question its efficacy in treating anorectal mucosal melanoma (ARMM). We aimed to identify the prevalence, current management, and overall survival (OS) for ARMM.METHODS:
Review of patients with ARMM from 2004 to 2015 National Cancer Database. Factors associated with immunotherapy were identified using multivariable logistic regression. The primary outcome was 2- and 5-year OS. Subgroup analysis by treatment type was performed.RESULTS:
A total of 1331 patients were identified with a significant increase in prevalence (2004 6.99%, 2015 10.53%). ARMM patients were older, white, on Medicare, and from the South. The most common treatment was surgery (48.77%), followed by surgery + radiation (11.75%), surgery + immunotherapy (8.68%), and surgery + chemotherapy (8.68%). 16.93% of patients received immunotherapy, with utilization increasing (7.24% 2004, 21.27% 2015, p < 0.001). Patients who received immunotherapy had a significantly better 2-year OS (42.47% vs. 49.21%, p < 0.001), and other therapies did not reveal a significant difference. Adjusted analysis showed no difference in 2- and 5-year OS based on therapy type.CONCLUSION:
The prevalence of ARMM has increased. The use of immunotherapy has increased substantially. Some survival benefit with the administration of immunotherapy may exist that has yet to be revealed. A more aggressive treatment paradigm is warranted.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias del Ano
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Neoplasias del Recto
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Antineoplásicos Inmunológicos
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Inmunoterapia
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Melanoma
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
/
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World J Surg
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos