Surgical treatment of anorectal malignant melanoma from single tertiary center: A retrospective analysis of 91 cases / 中国实用外科杂志

ABSTRACT

OBJECTIVE:To investigate the surgical treatment of anorectal malignant melanoma(ARMM) and the prognostic factors that affect patients' overall survival(OS).METHODS:Theclinical and pathological data of 91 patients diagnosed as ARMM, who underwent surgery in the Gastrointestinal Cancer Center of Peking University Cancer Hospital from January 2003 to January 2018 were retrospectively analyzed. The effects of different clinicopathological factors on OS of the patients, and difference surgery, abdominal-perineal resection(APR) and wide local excision(WLE) on patients' survival were compared.RESULTS:Of the 91 patients with ARMM, 35(38.5%) were male, 56(61.5%) were female, and the ratio of male to female was 1:1.6. 12 patients(13.2%) underwent wide local excision and 79 patients underwent abdominal-perineal resection(86.8%); there were 19 cases(20.9%) diagnosed with distant metastasis and 72 cases(79.1%)without distant metastasis. The of 1-, 3-, and 5-year survival rates of ARMM patients in this cohort were 74%, 23% and9%; and the median survival of the patients was 18.7 months. The univariate analysis of the clinicopathological features of the patients demonstrated that the preoperative distant metastases, tumor diameters(>2 cm), tumor invasion depth(>2 mm) and lymph node metastasis were the prognostic factors of OS; multivariate analysis showed that preoperative distant metastasis and lymph node metastasis were independent factors affecting OS.The median survival of the patients admitted APR and WLE were both 21 months. There was no significant difference in survival between the WLE and APR group(P=0.94).CONCLUSION:Preoperative distant metastasis and lymph node metastasis are independent prognostic factors for overall survival of ARMM patients.Comparing with WLE, APR could not bring survival benefits.