Anorectal melanoma in The Netherlands: a report of 63 patients.

A retrospective analysis was performed of the clinical features and results of surgical treatment modalities of 63 cases of anorectal melanoma collected in The Netherlands. Most tumours presented in an advanced stage due to the obscure location and lack of specific symptoms. There were 34 patients with clinical stage I disease who were treated by either local sphincter-saving surgery (n=16) or who had undergone an abdominoperineal resection (APR) (n=18). We could not find a survival advantage for either one of these two treatment modalities. However, after a local procedure far more local recurrences were seen (12:1), but this did not influence the clinical course of these patients, as they often rapidly succumbed to distant metastases. It is concluded that, in the future, patients presenting with an anorectal melanoma should be treated with a sphincter-saving surgical approach whenever possible.