Anorectal melanoma: experience from a tertiary cancer care centre in South India
Introduction Mucosal malignant melanoma of the anorectum is a rare and aggressive disease, in which early diagnosis is difficult. The prognosis remains extremely poor, irrespective of the treatment. We share our experience in treating this malignancy at our centre in South India. Methods This study...
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| Veröffentlicht in: | Annals of the Royal College of Surgeons of England 2018-03, Vol.100 (3), p.185-189 |
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| creator | Ranjith, S Muralee, M Sajeed, A Arun, P M Cherian, K Nair, C K Augustine, P Ahamed, I |
| description | Introduction Mucosal malignant melanoma of the anorectum is a rare and aggressive disease, in which early diagnosis is difficult. The prognosis remains extremely poor, irrespective of the treatment. We share our experience in treating this malignancy at our centre in South India. Methods This study describes a retrospective analysis of 31 cases of anorectal melanoma presented to our centre between January 2001 and December 2013. Results Twenty-two patients (71%) presented with metastasis and had a median overall survival of nine months. None of the 22 patients survived for two years. Nine patients (29%) had curative surgery, in the form of abdominoperineal resection (six patients), abdominoperineal resection with bilateral inguinal node dissection (one patient), abdominoperineal resection with liver resection (one patient) and posterior exenteration (one patient). In patients who underwent curative surgery, the median overall survival was 15 months and disease-free survival was nine months, with a two-year overall survival of 22%. Conclusions Anorectal melanoma is an aggressive disease with a poor prognosis. The majority of patients present with distant metastases. Prognosis depends on stage at presentation. Early diagnosis and surgical resection may improve the overall outcome. Newer modalities such as immunotherapy and targeted therapies such as anti-CTLA4 monoclonal antibody and anti-programmed cell death protein 1 monoclonal antibodies have radically changed the management of mucosal melanoma and may, in the future, improve the overall prognosis of anorectal melanoma. |
| doi_str_mv | 10.1308/rcsann.2017.0184 |
| format | Article |
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The prognosis remains extremely poor, irrespective of the treatment. We share our experience in treating this malignancy at our centre in South India. Methods This study describes a retrospective analysis of 31 cases of anorectal melanoma presented to our centre between January 2001 and December 2013. Results Twenty-two patients (71%) presented with metastasis and had a median overall survival of nine months. None of the 22 patients survived for two years. Nine patients (29%) had curative surgery, in the form of abdominoperineal resection (six patients), abdominoperineal resection with bilateral inguinal node dissection (one patient), abdominoperineal resection with liver resection (one patient) and posterior exenteration (one patient). In patients who underwent curative surgery, the median overall survival was 15 months and disease-free survival was nine months, with a two-year overall survival of 22%. Conclusions Anorectal melanoma is an aggressive disease with a poor prognosis. The majority of patients present with distant metastases. Prognosis depends on stage at presentation. Early diagnosis and surgical resection may improve the overall outcome. Newer modalities such as immunotherapy and targeted therapies such as anti-CTLA4 monoclonal antibody and anti-programmed cell death protein 1 monoclonal antibodies have radically changed the management of mucosal melanoma and may, in the future, improve the overall prognosis of anorectal melanoma.</description><identifier>ISSN: 0035-8843</identifier><identifier>EISSN: 1478-7083</identifier><identifier>DOI: 10.1308/rcsann.2017.0184</identifier><identifier>PMID: 29046101</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms - diagnosis ; Anus Neoplasms - mortality ; Anus Neoplasms - pathology ; Anus Neoplasms - therapy ; Biopsy ; Cancer therapies ; Chemotherapy ; Combined Modality Therapy ; Disease ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Humans ; India - epidemiology ; Liver ; Lower GI ; Lymphatic system ; Male ; Medical prognosis ; Melanoma ; Melanoma - diagnosis ; Melanoma - mortality ; Melanoma - pathology ; Melanoma - therapy ; Metastasis ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Oncology ; Palliative Care ; Patients ; Prognosis ; Radiation therapy ; Rectal Neoplasms - diagnosis ; Rectal Neoplasms - mortality ; Rectal Neoplasms - pathology ; Rectal Neoplasms - therapy ; Retrospective Studies ; Skin cancer ; Survival Analysis</subject><ispartof>Annals of the Royal College of Surgeons of England, 2018-03, Vol.100 (3), p.185-189</ispartof><rights>Copyright Royal College of Surgeons of England Mar 2018</rights><rights>Copyright © 2018, All rights reserved by the Royal College of Surgeons of England 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-840cfbeb7e01ed4684d3f1aef2245dabf91e2ba327e2a7cea515c8bc68d145053</citedby><cites>FETCH-LOGICAL-c424t-840cfbeb7e01ed4684d3f1aef2245dabf91e2ba327e2a7cea515c8bc68d145053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5930086/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5930086/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29046101$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ranjith, S</creatorcontrib><creatorcontrib>Muralee, M</creatorcontrib><creatorcontrib>Sajeed, A</creatorcontrib><creatorcontrib>Arun, P M</creatorcontrib><creatorcontrib>Cherian, K</creatorcontrib><creatorcontrib>Nair, C K</creatorcontrib><creatorcontrib>Augustine, P</creatorcontrib><creatorcontrib>Ahamed, I</creatorcontrib><title>Anorectal melanoma: experience from a tertiary cancer care centre in South India</title><title>Annals of the Royal College of Surgeons of England</title><addtitle>Ann R Coll Surg Engl</addtitle><description>Introduction Mucosal malignant melanoma of the anorectum is a rare and aggressive disease, in which early diagnosis is difficult. The prognosis remains extremely poor, irrespective of the treatment. We share our experience in treating this malignancy at our centre in South India. Methods This study describes a retrospective analysis of 31 cases of anorectal melanoma presented to our centre between January 2001 and December 2013. Results Twenty-two patients (71%) presented with metastasis and had a median overall survival of nine months. None of the 22 patients survived for two years. Nine patients (29%) had curative surgery, in the form of abdominoperineal resection (six patients), abdominoperineal resection with bilateral inguinal node dissection (one patient), abdominoperineal resection with liver resection (one patient) and posterior exenteration (one patient). In patients who underwent curative surgery, the median overall survival was 15 months and disease-free survival was nine months, with a two-year overall survival of 22%. Conclusions Anorectal melanoma is an aggressive disease with a poor prognosis. The majority of patients present with distant metastases. Prognosis depends on stage at presentation. Early diagnosis and surgical resection may improve the overall outcome. Newer modalities such as immunotherapy and targeted therapies such as anti-CTLA4 monoclonal antibody and anti-programmed cell death protein 1 monoclonal antibodies have radically changed the management of mucosal melanoma and may, in the future, improve the overall prognosis of anorectal melanoma.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anus Neoplasms - diagnosis</subject><subject>Anus Neoplasms - mortality</subject><subject>Anus Neoplasms - pathology</subject><subject>Anus Neoplasms - therapy</subject><subject>Biopsy</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Disease</subject><subject>Early Detection of Cancer</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Liver</subject><subject>Lower GI</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Melanoma</subject><subject>Melanoma - diagnosis</subject><subject>Melanoma - mortality</subject><subject>Melanoma - pathology</subject><subject>Melanoma - therapy</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Palliative Care</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Rectal Neoplasms - diagnosis</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - therapy</subject><subject>Retrospective Studies</subject><subject>Skin cancer</subject><subject>Survival Analysis</subject><issn>0035-8843</issn><issn>1478-7083</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkUFrFTEUhYMo9rW6dyUBN27meW-SmWRcCKVoLRRaUNchk7ljp8wkz2RG7L83z1eLdREOJOcezs3H2CuELUow75LPLoStANRbQKOesA0qbSoNRj5lGwBZV8YoecSOc74FwFYbfM6ORAuqQcANuz4NMZFf3MRnmlyIs3vP6deO0kjBEx9SnLnjC6VldOmOe1duU5FE3FNYioyBf4nrcsMvQj-6F-zZ4KZML-_1hH379PHr2efq8ur84uz0svJKqKUyCvzQUacJkHrVGNXLAR0NQqi6d93QIonOSaFJOO3J1Vh70_nG9KhqqOUJ-3DI3a3dTP2fLm6yuzTOpaeNbrSPX8J4Y7_Hn7ZuJYBpSsDb-4AUf6yUFzuP2dNUPoHimi22tRTlmLZY3_xnvY1rCmU9KwRIbJTWprjg4PIp5pxoeCiDYPe47AGX3eOye1xl5PW_SzwM_OUjfwN9-5Mw</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Ranjith, S</creator><creator>Muralee, M</creator><creator>Sajeed, A</creator><creator>Arun, P M</creator><creator>Cherian, K</creator><creator>Nair, C K</creator><creator>Augustine, P</creator><creator>Ahamed, I</creator><general>BMJ Publishing Group LTD</general><general>Royal College of Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>EHMNL</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180301</creationdate><title>Anorectal melanoma: experience from a tertiary cancer care centre in South India</title><author>Ranjith, S ; Muralee, M ; Sajeed, A ; Arun, P M ; Cherian, K ; Nair, C K ; Augustine, P ; Ahamed, I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-840cfbeb7e01ed4684d3f1aef2245dabf91e2ba327e2a7cea515c8bc68d145053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anus Neoplasms - diagnosis</topic><topic>Anus Neoplasms - mortality</topic><topic>Anus Neoplasms - pathology</topic><topic>Anus Neoplasms - therapy</topic><topic>Biopsy</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Combined Modality Therapy</topic><topic>Disease</topic><topic>Early Detection of Cancer</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Liver</topic><topic>Lower GI</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Melanoma</topic><topic>Melanoma - diagnosis</topic><topic>Melanoma - mortality</topic><topic>Melanoma - pathology</topic><topic>Melanoma - therapy</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Metastasis</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Palliative Care</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Rectal Neoplasms - diagnosis</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - therapy</topic><topic>Retrospective Studies</topic><topic>Skin cancer</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ranjith, S</creatorcontrib><creatorcontrib>Muralee, M</creatorcontrib><creatorcontrib>Sajeed, A</creatorcontrib><creatorcontrib>Arun, P M</creatorcontrib><creatorcontrib>Cherian, K</creatorcontrib><creatorcontrib>Nair, C K</creatorcontrib><creatorcontrib>Augustine, P</creatorcontrib><creatorcontrib>Ahamed, I</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>UK & Ireland Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the Royal College of Surgeons of England</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ranjith, S</au><au>Muralee, M</au><au>Sajeed, A</au><au>Arun, P M</au><au>Cherian, K</au><au>Nair, C K</au><au>Augustine, P</au><au>Ahamed, I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anorectal melanoma: experience from a tertiary cancer care centre in South India</atitle><jtitle>Annals of the Royal College of Surgeons of England</jtitle><addtitle>Ann R Coll Surg Engl</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>100</volume><issue>3</issue><spage>185</spage><epage>189</epage><pages>185-189</pages><issn>0035-8843</issn><eissn>1478-7083</eissn><abstract>Introduction Mucosal malignant melanoma of the anorectum is a rare and aggressive disease, in which early diagnosis is difficult. The prognosis remains extremely poor, irrespective of the treatment. We share our experience in treating this malignancy at our centre in South India. Methods This study describes a retrospective analysis of 31 cases of anorectal melanoma presented to our centre between January 2001 and December 2013. Results Twenty-two patients (71%) presented with metastasis and had a median overall survival of nine months. None of the 22 patients survived for two years. Nine patients (29%) had curative surgery, in the form of abdominoperineal resection (six patients), abdominoperineal resection with bilateral inguinal node dissection (one patient), abdominoperineal resection with liver resection (one patient) and posterior exenteration (one patient). In patients who underwent curative surgery, the median overall survival was 15 months and disease-free survival was nine months, with a two-year overall survival of 22%. Conclusions Anorectal melanoma is an aggressive disease with a poor prognosis. The majority of patients present with distant metastases. Prognosis depends on stage at presentation. Early diagnosis and surgical resection may improve the overall outcome. Newer modalities such as immunotherapy and targeted therapies such as anti-CTLA4 monoclonal antibody and anti-programmed cell death protein 1 monoclonal antibodies have radically changed the management of mucosal melanoma and may, in the future, improve the overall prognosis of anorectal melanoma.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>29046101</pmid><doi>10.1308/rcsann.2017.0184</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anus Neoplasms - diagnosis Anus Neoplasms - mortality Anus Neoplasms - pathology Anus Neoplasms - therapy Biopsy Cancer therapies Chemotherapy Combined Modality Therapy Disease Early Detection of Cancer Female Follow-Up Studies Humans India - epidemiology Liver Lower GI Lymphatic system Male Medical prognosis Melanoma Melanoma - diagnosis Melanoma - mortality Melanoma - pathology Melanoma - therapy Metastasis Middle Aged Neoplasm Metastasis Neoplasm Staging Oncology Palliative Care Patients Prognosis Radiation therapy Rectal Neoplasms - diagnosis Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - therapy Retrospective Studies Skin cancer Survival Analysis |
| title | Anorectal melanoma: experience from a tertiary cancer care centre in South India |
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