Surgery for gastrointestinal malignant melanoma: experience from surgical training center

Abstract

Aim: To characterize clinical features, surgery, outcome, and survival of malignant melanoma (MM) of the gastrointestinal (GI) tract in a surgical training center in Bangkok, Thailand.

Methods: A retrospective review was performed for all patients with MM of the GI tract treated at our institution between 1997 and 2007.

Results: Fourteen patients had GI involvement either in a metastatic form or as a primary melanoma. Thirteen patients with sufficient data were reviewed. The median age of the patients was 66 years (range: 32-87 years). Ten patients were female and three were male. Seven patients had primary melanomas of the anal canal, stomach and the sigmoid colon (5, 1 and 1 cases, respectively). Seven patients underwent curative resections: three abdominoperineal resections, two wide local excisions, one total gastrectomy and one sigmoidectomy. Six patients had distant metastatic lesions at the time of diagnosis, which made curative resection an inappropriate choice. Patients who underwent curative resection exhibited a longer mean survival time (29.7 mo, range: 10-96 mo) than did patients in the palliative group (4.8 mo, P = 0.0006).

Conclusion: GI MM had an unfavorable prognosis, except in patients who underwent curative resection (53.8% of cases), who had a mean survival of 29.7 mo.

Figure 1

Kaplan-Meier curve demonstrating survival of patients with malignant melanoma of the gastrointestinal tract, who underwent curative resection and palliative resection.