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Trends in the management of anorectal melanoma:A multiinstitutional retrospective study and review of the world literature

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World Journal of Gastroenterology 2021年第3期27卷 267-280页

作者： Josh Bleicher Jessica N Cohan Lyen C Huang William Peche T Bartley Pickron Courtney L Scaife Tawnya L Bowles John R Hyngstrom elliot a asare Department of Surgery Huntsman Cancer Institute at the University of UtahSalt Lake CityUT 84114United States Department of Surgery George E Wahlen Department of Veterans Affairs Medical CenterSalt Lake CityUT 84114United States Department of Surgery Intermountain Medical CenterMurrayUT 84107United States

BACKGROUND Anorectal melanoma(ARM)is a rare disease with a poor *** on optimal treatment is limited and surgical management varies *** hypothesized that the frequency of abdominoperineal resection used as primary treatment of ARM has decreased over the past several *** To update our understanding of outcomes for patients with ARM and analyze management trends around the *** This is a multi-institutional,retrospective study of patients treated for ARM at 7 *** included both large,academic,tertiary care centers and smaller,general community *** prospectively maintained institutional tumor registries,we identified 24 patients diagnosed with ARM between January 2000 and May *** analyzed factors prognostic for recurrence and *** then used Cox regression to measure overall survival(OS)and melanoma-specific *** also performed a literature review to assess trends in surgical management and *** Of the 24 patients diagnosed with ARM,12(50.0%)had local,8(33.3%)regional,and 4(16.7%)distant disease at *** time to recurrence was 10.4 mo[interquartile range(IQR)7.5-17.2]with only 2 patients(9.3%)not developing recurrence following surgical *** OS was 18.8 mo(IQR 13.5-33.9).One patient is still alive without recurrence at 21.4 mo from diagnosis;no other patient survived 5 *** surgical management with abdominoperineal resection(APR)vs wide excision(WE)did not lead to differences in OS[hazard ratio=1.4(95%CI:0.3-6.8)].Review of the literature revealed geographic differences in surgical management of ARM,with increased use of WE in the United States and Europe over time and more frequent use of APR in Asia and *** was no significant improvement in survival over *** There is wide variation in the management of ARM and survival outcomes remain poor regardless of *** management should aim to minimize morbidity.

关键词： Melanoma Anorectal melanoma Literature review Melanoma surgery Surgical oncology Colorectal surgery

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