Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2017; 06(04): 147-150
DOI: 10.4103/sajc.sajc_276_16
Original Article : Gastro-intestinal & Hepatobiliary Cancers

Metastatic anorectal melanomas – An exploratory retrospective analysis on the benefits of systemic therapy versus best supportive care in a resource-limited setting from India

Arvind Sahu
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Anant Ramaswamy
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Nitin Singhal
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Vipul Doshi
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Jimmy Mirani
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Ashwin Desouza
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Shripad Banavali
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Avanish Saklani
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
,
Vikas Ostwal
Consultant Haemato-Oncologist, Kingston and Royal Marsden Hospitals, London, UK
› Author Affiliations Source of Support: Nill.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Aim: Data regarding the optimal management of metastatic anorectal melanoma (mARM) is scarce. The primary aim was to evaluate the potential benefits of systemic therapy in mARM. Materials and Methods: This is a retrospective analysis of all mARM who presented between July 2013 and June 2015 at the Department of GI Medical Oncology, Tata Memorial Hospital. Results: Of a total of 37 patients, twelve patients were planned for best supportive care (BSC) only while the remaining 25 patients received systemic therapy. The median overall survival (OS) for the whole cohort was 27 weeks. The OS was significantly better in patients who received first-line therapy as compared to those who were offered BSC (median OS: 14 vs. 33 weeks; P = 0.04). Patients with PS of 1 did significantly better than PS of 2 more (OS 70 vs. 17 weeks; P = 0.015). Conclusion: mARM should be offered chemotherapy, especially in good performance patients. Paclitaxel/Platinum or Capecitabine/Temozolomide regimens can be considered as the preferred regime in the resource-limited setting where immunotherapy may not be a feasible option.

Key words

Anorectal melanoma - chemotherapy - metastatic - overall survival


Publication History

Article published online:
22 December 2020

© 2017. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: A summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 1998;83:1664-78.
  • 2 Mihajlovic M, Vlajkovic S, Jovanovic P, Stefanovic V. Primary mucosal melanomas: A comprehensive review. Int J Clin Exp Pathol 2012;5:739-53.
  • 3 Row D, Weiser MR. Anorectal melanoma. Clin Colon Rectal Surg 2009;22:120-6.
  • 4 Cagir B, Whiteford MH, Topham A, Rakinic J, Fry RD. Changing epidemiology of anorectal melanoma. Dis Colon Rectum 1999;42:1203-8.
  • 5 Iddings DM, Fleisig AJ, Chen SL, Faries MB, Morton DL. Practice patterns and outcomes for anorectal melanoma in the USA, reviewing three decades of treatment: Is more extensive surgical resection beneficial in all patients? Ann Surg Oncol 2010;17:40-4.
  • 6 Rossetti C, Koukouras D, Eboli M, Andreola S, Bertario L. Primary anorectal melanomas: An istitutional experience. J Exp Clin Cancer Res 1997;16:81-5.
  • 7 Sasaki S, Kojima T, Hidemura A, Hatanaka K, Uekusa T, Ishimaru M. A case report of anorectal malignant melanoma showing a complete response after DTIC/ACNU/VCR therapy. Gan To Kagaku Ryoho 2010;37:1999-2002.
  • 8 Kim KB, Sanguino AM, Hodges C, Papadopoulos NE, Eton O, Camacho LH, et al. Biochemotherapy in patients with metastatic anorectal mucosal melanoma. Cancer 2004;100:1478-83.
  • 9 Ulmer A, Metzger S, Fierlbeck G. Successful palliation of stenosing anorectal melanoma by intratumoral injections with natural interferon-beta. Melanoma Res 2002;12:395-8.
  • 10 Yeh JJ, Weiser MR, Shia J, Hwu WJ. Response of stage IV anal mucosal melanoma to chemotherapy. Lancet Oncol 2005;6:438-9.
  • 11 Biochemotherapy in Patients with Advanced Vulvovaginal Mucos : Melanoma Research. LWW. Available from: http://www.journals.lww.com/melanomaresearch/Fulltext/2004/12000/Biochemotherapy_in_patients_with_advanced. 12.aspx. [Last accessed on 2016 Feb 05].
  • 12 Medina JE, Ferlito A, Pellitteri PK, Shaha AR, Khafif A, Devaney KO, et al. Current management of mucosal melanoma of the head and neck. J Surg Oncol 2003;83:116-22.
  • 13 Bartell HL, Bedikian AY, Papadopoulos NE, Dett TK, Ballo MT, Myers JN, et al. Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 2008;30:1592-8.
  • 14 Rosenberg SA, Yang JC, Schwartzentruber DJ, Hwu P, Marincola FM, Topalian SL, et al. Prospective randomized trial of the treatment of patients with metastatic melanoma using chemotherapy with cisplatin, dacarbazine, and tamoxifen alone or in combination with interleukin-2 and interferon alfa-2b. J Clin Oncol 1999;17:968-75.
  • 15 Cherny N, Sullivan R, Torode J, Saar M, Eniu A. ESMO European Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in Europe. Ann Oncol 2016;27:1423-43.
  • 16 Mayor S. Differences in availability of cancer drugs across Europe. Lancet Oncol 2016;17:1196.
  • 17 Siddiqui M, Rajkumar SV. The high cost of cancer drugs and what we can do about it. Mayo Clin Proc 2012;87:935-43.
  • 18 PAA; 2012. Available from: http://www.paa2012.princeton.edu/abstracts/121467. [Last accessed on 2016 Oct 29].
  • 19 Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-47.
  • 20 Brady MS, Kavolius JP, Quan SH. Anorectal melanoma. A 64-year experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum 1995;38:146-51.
  • 21 Roumen RM. Anorectal melanoma in The Netherlands: A report of 63 patients. Eur J Surg Oncol 1996;22:598-601.
  • 22 Belli F, Gallino GF, Lo Vullo S, Mariani L, Poiasina E, Leo E. Melanoma of the anorectal region: The experience of the National Cancer Institute of Milano. Eur J Surg Oncol 2009;35:757-62.
  • 23 Podnos YD, Tsai NC, Smith D, Ellenhorn JD. Factors affecting survival in patients with anal melanoma. Am Surg 2006;72:917-20.