Effect of misdiagnosis on the prognosis of anorectal malignant melanoma

ObjectiveAnorectal malignant melanoma (AMM) is frequently subjected to misdiagnosis. Here the effect of misdiagnosis on the prognosis of AMM was investigated.MethodsBetween 1995 and 2007, 79 patients managed for AMM were reviewed; 46 (58.23%) of them had been misdiagnosed during the symptoms, while 33 (41.77%) cases had been diagnosed exactly not more than 1 week after the first visit. Diseases misdiagnosed were categorized as cancer, hemorrhoids, polyps and other diseases. Data were statistically analyzed by using the life tables and Kaplan–Meier curves. The software used was SPSS 16.0 for Windows.ResultsThe 1-, 2-, 3- and 5-year survival rates of AMM patients were 58, 33, 24 and 16%, respectively, and the median survival time was 14.0 months; 1-, 2-, 3- and 5-year survival rates of the misdiagnosed patients were 61, 22, 22 and 11%, respectively, and the median survival time was 14.0 months; 1-, 2-, 3- and 5-year survival rates of the patients not misdiagnosed were 55, 44, 25 and 25%, respectively, and the median survival time was 12.0 months. Analyses based on Kaplan–Meier curves revealed no significant effect of misdiagnosis on the survival of AMM patients (P > 0.05). Nevertheless, the diseases misdiagnosed significantly affect the prognosis (P = 0.009); AMM misdiagnosed as hemorrhoids had a poor prognosis, with a 1-year survival rate of only 29% and the median survival of only 6.0 months.ConclusionsThe misdiagnosed patients had relatively poor prognosis, but the effect of misdiagnosis on the prognosis was not significant; however, misdiagnosis of AMM as hemorrhoids seriously affected the prognosis.

[1]  T. Hull,et al.  Long-Term Survivor of Anorectal Melanoma , 2002 .

[2]  L. Påhlman,et al.  Anorectal malignant melanoma in Sweden , 1990, Diseases of the colon and rectum.

[3]  T. Hull,et al.  What is the best surgical treatment for anorectal melanoma? , 2004, International Journal of Colorectal Disease.

[4]  S. Metzger,et al.  Successful palliation of stenosing anorectal melanoma by intratumoral injections with natural interferon-β , 2002, Melanoma research.

[5]  Y. Bang,et al.  Malignant Melanoma of the Anorectal Region , 2002 .

[6]  M. Pocard,et al.  Surgical management of primary anorectal melanoma , 2004, The British journal of surgery.

[7]  Jeffrey E. Lee,et al.  Biochemotherapy in patients with metastatic anorectal mucosal melanoma , 2004, Cancer.

[8]  M. Hussein Extracutaneous Malignant Melanomas , 2008, Cancer investigation.

[9]  K. D. Fine,et al.  Comparison of the color of fecal blood with the anatomical location of gastrointestinal bleeding lesions: potential misdiagnosis using only flexible sigmoidoscopy for bright red blood per rectum , 1999, American Journal of Gastroenterology.

[10]  P. Fragapane,et al.  Primary Anorectal Malignant Melanoma: Report of two Cases , 2000, Tumori.

[11]  C. Slingluff,et al.  Anorectal melanoma: clinical characteristics and results of surgical management in twenty-four patients. , 1990, Surgery.

[12]  Jeffrey E. Lee,et al.  Sphincter-sparing local excision and adjuvant radiation for anal-rectal melanoma. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  D. Ilstrup,et al.  Anorectal melanoma—An incurable disease? , 1997, Diseases of the colon and rectum.

[14]  E. Balthazar,et al.  The radiology corner. Anorectal melanoma. , 1975, The American journal of gastroenterology.

[15]  T. Hull,et al.  Long-term survivor of anorectal melanoma: report of a case. , 2002, Diseases of the colon and rectum.

[16]  S. Köklü,et al.  Primary anorectal malignant melanoma: two case reports and review of the literature. , 2007, Clinical colorectal cancer.

[17]  M. McKay,et al.  Dispelling the myths surrounding radiotherapy for treatment of cutaneous melanoma. , 2006, The Lancet. Oncology.

[18]  M. Volkenandt,et al.  Malignant melanoma of the anal region , 2007, Clinical and experimental dermatology.

[19]  L. French,et al.  Neurotrophins and their receptors stimulate melanoma cell proliferation and migration. , 2008, The Journal of investigative dermatology.

[20]  P. Neary,et al.  A comparison of wide local excision with abdominoperineal resection in anorectal melanoma , 2004, Melanoma research.

[21]  J. R. Lee,et al.  Anal melanoma: an aggressive malignancy masquerading as hemorrhoids. , 2001, Southern medical journal.

[22]  G. Farr,et al.  Anorectal melanoma , 1981, Cancer.

[23]  R. Roumen,et al.  Anorectal melanoma in The Netherlands: a report of 63 patients. , 1996, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.