Survival following surgical treatment for anorectal melanoma seems similar for local excision and extensive resection regardless of nodal involvement

Recent breakthroughs in the treatment of melanoma are associated with the systemic therapy by drugs of new classes, however, the place of surgery remains to be the main in the management of both localized and widespread melanoma. In this literature review, there are systematized the modern concepts of local excision of the primary tumor, the value of biopsy of sentinel lymph node and possibilities of surgical treatment of distant metastases of melanoma.

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Reply to letter regarding ???A comparison of wide local excision with abdominoperineal resection in anorectal melanoma???, published in April 2004

Melanoma Research ◽

10.1097/00008390-200412000-00021 ◽

2004 ◽

Vol 14 (6) ◽

pp. 565-565

Author(s):

Paul Neary ◽

Lok B. Yap

Keyword(s):

Abdominoperineal Resection ◽

Local Excision ◽

Wide Local Excision ◽

Anorectal Melanoma

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Analysis of Risk Factors for Lymph Nodal Involvement in Early Stages of Rectal Cancer: When Can Local Excision Be Considered an Appropriate Treatment? Systematic Review and Meta-Analysis of the Literature

International Journal of Surgical Oncology ◽

10.1155/2012/438450 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Alessandro Carrara ◽

Daniela Mangiola ◽

Riccardo Pertile ◽

Alberta Ricci ◽

Michele Motter ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Local Excision ◽

Radical Surgery ◽

Meta Analysis ◽

Nodal Involvement ◽

Node Metastasis ◽

Early Stages

Background. Over the past ten years oncological outcomes achieved by local excision techniques (LETs) as the sole treatment for early stages of rectal cancer (ESRC) have been often disappointing. The reasons for these poor results lie mostly in the high risk of the disease's diffusion to local-regional lymph nodes even in ESRC.Aims. This study aims to find the correct indications for LET in ESRC taking into consideration clinical-pathological features of tumours that may reduce the risk of lymph node metastasis to zero.Methods. Systematic literature review and meta-analysis of casistics of ESRC treated with total mesorectal excision with the aim of identifying risk factors for nodal involvement.Results. The risk of lymph node metastasis is higher inG≥2andT≥2tumours with lymphatic and/or vascular invasion. Other features which have not yet been sufficiently investigated include female gender, TSM stage >1, presence of tumour budding and/or perineural invasion.Conclusions. Results comparable to radical surgery can be achieved by LET only in patients with T1N0G1tumours with low-risk histological features, whereas deeper or more aggressive tumours should be addressed by radical surgery (RS).

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