Department of Abdominal Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Chin Med J (Engl). 2010 Mar 5;123(5):585-8.
Anorectal malignant melanoma was a rare disease with extremely poor prognosis. The aim of this study was to explore the clinical characteristic, diagnosis and treatment strategies of anorectal malignant melanoma.
The data of 57 patients with anorectal malignant melanoma was collected and retrospectively analyzed.
Rectal bleeding and anal mass were found to be common symptoms of anorectal malignant melanoma. The preoperative diagnosis rate of anorectal malignant melanoma was 48.6%. The overall 3-year and 5-year survival rate was 38.0% and 21.3% respectively. The 3-year survival rates of stage I and II patients were 63.0% and 16.7% respectively (P = 0.000), and the 5-year survival rates were 33.3% and 11.1% (P = 0.001), which both had significant statistic differences. The 3-year survival rate of patients undergone abdmoninoperineal resection and patients undergone wide local excision were 36.7% and 53.0% respectively (P = 0.280), while the 5-year survival rate were 24.1% and 23.1% (P = 0.642), which both had no significant statistic differences.
This study identified no survival advantage to abdominoperineal resection in treatment of anorectal malignant melanoma, and we propose that wide local excision could be considered as the initial treatment of choice.
肛门直肠恶性黑色素瘤是一种预后极差的罕见疾病。本研究旨在探讨肛门直肠恶性黑色素瘤的临床特征、诊断和治疗策略。
收集并回顾性分析了 57 例肛门直肠恶性黑色素瘤患者的数据。
直肠出血和肛门肿块是肛门直肠恶性黑色素瘤的常见症状。肛门直肠恶性黑色素瘤的术前诊断率为 48.6%。总体 3 年和 5 年生存率分别为 38.0%和 21.3%。Ⅰ期和Ⅱ期患者的 3 年生存率分别为 63.0%和 16.7%(P = 0.000),5 年生存率分别为 33.3%和 11.1%(P = 0.001),均有统计学差异。腹会阴联合切除术和广泛局部切除术患者的 3 年生存率分别为 36.7%和 53.0%(P = 0.280),5 年生存率分别为 24.1%和 23.1%(P = 0.642),均无统计学差异。
本研究未发现腹会阴联合切除术在治疗肛门直肠恶性黑色素瘤中有生存优势,我们提出广泛局部切除术可作为初始治疗的首选。