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Anorectal melanomas: time for immunotherapy

In Colorectal Disease
By: Chatterjee A.
Contributor(s): Ostwal V | Engineer R | Bankar S | Sharma V | Desouza A | Saklani A.
Material type: materialTypeLabelArticlePublisher: 2020Description: .Subject(s): Anorectal melanoma | Surgery | Chemotherapy | Immunotherapy | Survival In: Colorectal Disease Vol. 22, no. (Supple1), p. 24.Summary: Introduction: Anorectal melanoma (AM) is a type of mucosal melanoma which is rare and has poor outcomes. Most patients are diagnosed in advanced stage and not treated with curative intent. Surgery is the mainstay in non‐metastatic patients and is the only curative treatment option. Methodology: We retrospectively studied 154 AM patients treated in a single institution between November 2010 and September 2019. We looked at the presentation, use of PET scan for staging, and outcomes of metastatic and non‐metastatic patients. Median follow‐up duration was 30 months. Results: Out of 154 patients, 110 patients were metastatic and 44 were non‐metastatic at presentation. PET scan was done for 39 out of 44 patients, with a sensitivity and accuracy of 78.95% and 74.36% respectively for detecting pN stage. Three patients had positive CRM. The median overall survival (OS) of operated patients was 33 months (3‐year OS of 41%). Adjuvant systemic therapy (chemotherapy/immunotherapy) was given to only seven patients after curative resection. Overall recurrence rate was 52.2%. In metastatic patients, median OS was 3 months (1‐year OS 15.5%). Patients who received systemic therapy had significant survival benefit than those who did not (median OS for chemotherapy: 8 months vs. < 1 month; P = 0.001). Conclusion: In a disease with poor outcome, even in resectable disease, role of immunotherapy in neoadjuvant, adjuvant and metastatic setting needs to be explored. This study gives an insight on management of localized and metastatic AM, role of PET scan, systemic therapy, and long‐term survival of these patients.
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Articles Articles Tata Memorial Hospital
Available AR20262

Association of Coloproctology of Great Britain and Ireland Annual Meeting, 6–8 July 2020, Edinburgh, UK

Introduction: Anorectal melanoma (AM) is a type of mucosal melanoma which is rare and has poor outcomes. Most patients are diagnosed in advanced stage and not treated with curative intent. Surgery is the mainstay in non‐metastatic patients and is the only curative treatment option.
Methodology: We retrospectively studied 154 AM patients treated in a single institution between November 2010 and September 2019. We looked at the presentation, use of PET scan for staging, and outcomes of metastatic and non‐metastatic patients. Median follow‐up duration was 30 months.
Results: Out of 154 patients, 110 patients were metastatic and 44 were non‐metastatic at presentation. PET scan was done for 39 out of 44 patients, with a sensitivity and accuracy of 78.95% and 74.36% respectively for detecting pN stage. Three patients had positive CRM. The median overall survival (OS) of operated patients was 33 months (3‐year OS of 41%). Adjuvant systemic therapy (chemotherapy/immunotherapy) was given to only seven patients after curative resection. Overall recurrence rate was 52.2%. In metastatic patients, median OS was 3 months (1‐year OS 15.5%). Patients who received systemic therapy had significant survival benefit than those who did not (median OS for chemotherapy: 8 months vs. < 1 month; P = 0.001).
Conclusion: In a disease with poor outcome, even in resectable disease, role of immunotherapy in neoadjuvant, adjuvant and metastatic setting needs to be explored. This study gives an insight on management of localized and metastatic AM, role of PET scan, systemic therapy, and long‐term survival of these patients.

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