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Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study
BACKGROUND: Anorectal melanoma is a rare tumor with a dismal prognosis. The only promising treatment for anorectal melanoma is surgery, either extensive resection (ER) or local excision (LE). However, the optimal extent of resection is still controversial. The purpose of this study was to investigat...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468230/ https://www.ncbi.nlm.nih.gov/pubmed/36111221 http://dx.doi.org/10.3389/fsurg.2022.997169 |
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author | Liu, Chang Tang, Cuiping Zhang, Jianbo Zhu, Peng |
author_facet | Liu, Chang Tang, Cuiping Zhang, Jianbo Zhu, Peng |
author_sort | Liu, Chang |
collection | PubMed |
description | BACKGROUND: Anorectal melanoma is a rare tumor with a dismal prognosis. The only promising treatment for anorectal melanoma is surgery, either extensive resection (ER) or local excision (LE). However, the optimal extent of resection is still controversial. The purpose of this study was to investigate whether the survival outcomes of anorectal melanoma at different stages are influenced by the surgical approaches (LE or ER) using the National Institute of Health's Surveillance, Epidemiology, and End Results Program (SEER) database. METHODS: The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients treated for anorectal melanoma (2000–2018). Overall survival (OS) and disease-specific survival (DSS) outcomes were compared for the two surgical approaches (ER or LE) stratified by stage (localized, regional and distant). RESULTS: A total of 736 patients were included in the study. Details of previous surgical procedures were available for 548 of the study patients: 360 (65.7%) underwent LE, and 188 (34.3%) underwent ER. In localized cases, 199 underwent LE, and 48 underwent ER. The OS (median 45 vs. 29 months, 5-year rate 41.7% vs. 23.4%) and DSS (median 66 vs. 34 months, 5-year rate 51% vs. 30.7%) of patients undergoing ER were significantly better (p = 0.009 and 0.041, respectively) than those who received LE. Multivariate analysis showed that the type of surgery was an independent prognostic factor for both OS and DSS. Among the regional cases, 89 cases had LE, and 96 cases had ER. Patients with regional disease who underwent ER had no significant differences in OS (23 vs. 21 months; p = 0.866) or DSS (24 vs. 24 months; p = 0. 907) compared to patients who underwent LE. In distant cases, 72 cases had LE, and 44 cases had ER. Patients with metastatic disease who had ER also had similar OS (median 11 vs. 8 months; p = 0.36) and DSS (median 11 vs. 8 months; p = 0.593) to those who underwent LE. CONCLUSION: Extensive resection can improve the long-term prognosis of localized anorectal melanoma compared to local excision, but the prognosis of the two surgical techniques is comparable in both regional patients and distant patients. |
format | Online Article Text |
id | pubmed-9468230 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94682302022-09-14 Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study Liu, Chang Tang, Cuiping Zhang, Jianbo Zhu, Peng Front Surg Surgery BACKGROUND: Anorectal melanoma is a rare tumor with a dismal prognosis. The only promising treatment for anorectal melanoma is surgery, either extensive resection (ER) or local excision (LE). However, the optimal extent of resection is still controversial. The purpose of this study was to investigate whether the survival outcomes of anorectal melanoma at different stages are influenced by the surgical approaches (LE or ER) using the National Institute of Health's Surveillance, Epidemiology, and End Results Program (SEER) database. METHODS: The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients treated for anorectal melanoma (2000–2018). Overall survival (OS) and disease-specific survival (DSS) outcomes were compared for the two surgical approaches (ER or LE) stratified by stage (localized, regional and distant). RESULTS: A total of 736 patients were included in the study. Details of previous surgical procedures were available for 548 of the study patients: 360 (65.7%) underwent LE, and 188 (34.3%) underwent ER. In localized cases, 199 underwent LE, and 48 underwent ER. The OS (median 45 vs. 29 months, 5-year rate 41.7% vs. 23.4%) and DSS (median 66 vs. 34 months, 5-year rate 51% vs. 30.7%) of patients undergoing ER were significantly better (p = 0.009 and 0.041, respectively) than those who received LE. Multivariate analysis showed that the type of surgery was an independent prognostic factor for both OS and DSS. Among the regional cases, 89 cases had LE, and 96 cases had ER. Patients with regional disease who underwent ER had no significant differences in OS (23 vs. 21 months; p = 0.866) or DSS (24 vs. 24 months; p = 0. 907) compared to patients who underwent LE. In distant cases, 72 cases had LE, and 44 cases had ER. Patients with metastatic disease who had ER also had similar OS (median 11 vs. 8 months; p = 0.36) and DSS (median 11 vs. 8 months; p = 0.593) to those who underwent LE. CONCLUSION: Extensive resection can improve the long-term prognosis of localized anorectal melanoma compared to local excision, but the prognosis of the two surgical techniques is comparable in both regional patients and distant patients. Frontiers Media S.A. 2022-08-30 /pmc/articles/PMC9468230/ /pubmed/36111221 http://dx.doi.org/10.3389/fsurg.2022.997169 Text en © 2022 Liu, Tang, Zhang and Zhu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Liu, Chang Tang, Cuiping Zhang, Jianbo Zhu, Peng Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study |
title | Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study |
title_full | Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study |
title_fullStr | Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study |
title_full_unstemmed | Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study |
title_short | Extensive resection improves overall and disease-specific survival in localized anorectal melanoma: A SEER-based study |
title_sort | extensive resection improves overall and disease-specific survival in localized anorectal melanoma: a seer-based study |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468230/ https://www.ncbi.nlm.nih.gov/pubmed/36111221 http://dx.doi.org/10.3389/fsurg.2022.997169 |
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