Weyandt G H, Eggert A O, Houf M, Raulf F, Bröcker E B, Becker J C
Department of Dermatology, Julius Maximilians University Würzburg, Josef Schneidr Str. 2, Würzburg 97080, Germany.
Br J Cancer. 2003 Dec 1;89(11):2019-22. doi: 10.1038/sj.bjc.6601409.
Management of patients with anorectal melanoma is still controversial. To reach a rationale therapeutic approach, we reviewed our experience obtained over the past decade. In all, 19 consecutive patients with the diagnosis of anorectal melanoma were included in this retrospective survey. Details of the patients' presentation, symptoms, tumour size and histology and tumour state were recorded, and the primary therapeutic procedures were evaluated in detail. The size of the tumours ranged between 0.5 and 7 cm in diameter. The median tumour thickness was 10 mm (range 0.6-40 mm). At diagnosis, six of 19 patients already presented with either regional or distant metastases. The remaining 13 patients were treated with curative intend, either by abdomino-perineal resection (APR) or wide local excision (WLE). The form of operative therapy, however, had no impact on overall survival. Nevertheless, the incidence of local recurrences was lower after APR even for patients with less favourable tumours. In conclusion, WLE alone is not sufficient for local tumour control of thick anorectal melanoma.
肛管黑色素瘤患者的治疗仍存在争议。为了找到合理的治疗方法，我们回顾了过去十年的经验。在这项回顾性研究中，共纳入了19例连续诊断为肛管黑色素瘤的患者。记录了患者的临床表现、症状、肿瘤大小、组织学和肿瘤状态的详细信息，并对主要治疗方法进行了详细评估。肿瘤直径在0.5至7厘米之间。肿瘤的中位厚度为10毫米（范围为0.6至40毫米）。诊断时，19例患者中有6例已出现区域或远处转移。其余13例患者接受了根治性治疗，采用腹会阴联合切除术（APR）或广泛局部切除术（WLE）。然而，手术治疗方式对总生存率没有影响。尽管如此，即使对于肿瘤情况不太好的患者，APR术后局部复发的发生率也较低。总之，单纯的WLE不足以控制厚型肛管黑色素瘤的局部肿瘤。
