In a nutshell
This study compared the afety and effectiveness of two surgical treatments for anal melanoma. The study found that patients who had a local excision and patients who had an abdominoperineal resection had the same level of overall survival.
Some background
Anal melanoma is a very rare cancer. Two surgical options for treatment are currently used. Local excision involves removing the tumor and a small amount of the surrounding tissue. Abdominoperineal resection (APR) is a more aggressive treatment and involves removing the anus, rectum, and part of the colon. There are some studies that suggest that APR might result in better survival.
Methods & findings
There were 653 patients in this study. Of these, 439 underwent local excision of their tumor and 214 underwent APR surgery. The patients in the APR group had more aggressive cancer overall, they were more likely to have larger tumors and positive lymph nodes compared to the local excision group.
The overall survival rate in the patients who underwent local excision was 64%, compared to 67% in the APR group. Patients in both groups who had no cancer in their lymph nodes and no remaining cancer cells near the surgical area, were more likely to survive.
The bottom line
The study concluded that there was no difference in survival of patients who underwent local excision compared to patients who underwent the more aggressive APR surgery in treatment of anal melanoma.
The fine print
This is the largest study done on surgical treatment of anal melanoma. Because it is such a rare cancer it is difficult to get enough patient data to get significant results. This study had a large number of patients, which makes this a very important study in this field. There was no analysis of how the different types of surgery affected the quality of life of the patients. This should be addressed in a further study.
What’s next?
Discuss your treatment plan with your oncologist.
Published By :
Annals of Surgical Oncology
Date :
Sep 12, 2018