Mr Myles Smith and colleagues from the The Sarcoma, Melanoma and Rare Tumours Unit at the Royal Marsden, have just had a study published, titled ‘Surgical Management of Primary Anorectal Melanoma: Is Less More?’ in the Journal of Gastrointestinal Cancer.
Anorectal melanoma is a rare disease, accounting for less than 2% of malignant melanomas. Usually occurring in the anal canal and in the rectum, they often go undiagnosed with symptoms being mistaken for benign anorectal conditions including adenomatous polyps or haemorrhoids, meaning delays in diagnosis and treatment.
Ano-uro-genital (AUG) Mucosal Melanoma UK guidelines recommend using less radical surgical techniques for treating anorectal melanoma where possible.
The retrospective study looked at the outcomes of patients treated surgically for anorectal melanoma, comparing those treated with wide local excision, with those who received radical abdominoperineal resections. By reviewing the demographics, diagnosis, treatment and oncological outcomes, the study concluded that adhering to the guidelines and achieving clear margins by the least radical fashion had acceptable results. Also, by using conservative surgery could mean potentially reducing patient morbidity and preserving function.