Richard Sassun, Annaclara Sileo, Jyi Cheng Ng, Davide Ferrari, Matthew S Block, William R G Perry, Nicholas P McKenna, Kristen K Rumer, David W Larson
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Two cohorts were created based on the surgical approach (LS or RS). In their respective cohorts, patients receiving Neo-IT, Adj-IT, or Adj-CHT were matched 1:1:1 based on age, tumor size and location, lymphovascular invasion, and nodal disease. Kaplan-Meier analyses compared the different groups' influence on the 3-year OS.</p><p><strong>Results: </strong>Sixty patients were included in the LS cohort. Among them, there was no difference in the 3-year OS at the Kaplan-Meier analysis (Neo-IT 61%, Adj-IT 47.1%, and Adj-CHT 44%). Thirty-six patients were included in the RS cohort. Kaplan-Meier analysis for this group revealed that Neo-IT was a protective factor for 3-year OS (Neo-IT 71%, Adj-IT 11%, Adj-CHT 8%; p-value = 0.002).</p><p><strong>Conclusion: </strong>Neo-IT + RS seems to improve the 3-year OS compared to the other common treatments for ARM. Neo-IT + RS can be considered a valuable treatment since prospective trials are challenging for rare diseases. When RS is not feasible, Neo-IT + LS may be beneficial as the 3-year OS reaches 61%.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"108"},"PeriodicalIF":1.6000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multidisciplinary Management of Anorectal Melanoma: a Retrospective Analysis of Surgical and Systemic Therapies from the National Cancer Database.\",\"authors\":\"Richard Sassun, Annaclara Sileo, Jyi Cheng Ng, Davide Ferrari, Matthew S Block, William R G Perry, Nicholas P McKenna, Kristen K Rumer, David W Larson\",\"doi\":\"10.1007/s12029-025-01234-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Anorectal melanoma (ARM) represents a problematic scenario due to a 5-year overall survival (OS) rate below 20% and its increasing incidence. Due to its comparable OS, local surgery (LS) has replaced radical surgery (RS). Adjuvant chemotherapy (Adj-CHT) and adjuvant immunotherapy (Adj-IT) are common treatments for ARM, while neoadjuvant immunotherapy (Neo-IT) has not been investigated yet. This study aimed to determine the best treatment to improve the OS.</p><p><strong>Methods: </strong>Patients with non-metastatic ARM in the National Cancer 1Database (2011-2021) who underwent surgery and received Neo-IT, Adj-IT, or Adj-CHT were included. Two cohorts were created based on the surgical approach (LS or RS). In their respective cohorts, patients receiving Neo-IT, Adj-IT, or Adj-CHT were matched 1:1:1 based on age, tumor size and location, lymphovascular invasion, and nodal disease. Kaplan-Meier analyses compared the different groups' influence on the 3-year OS.</p><p><strong>Results: </strong>Sixty patients were included in the LS cohort. Among them, there was no difference in the 3-year OS at the Kaplan-Meier analysis (Neo-IT 61%, Adj-IT 47.1%, and Adj-CHT 44%). Thirty-six patients were included in the RS cohort. Kaplan-Meier analysis for this group revealed that Neo-IT was a protective factor for 3-year OS (Neo-IT 71%, Adj-IT 11%, Adj-CHT 8%; p-value = 0.002).</p><p><strong>Conclusion: </strong>Neo-IT + RS seems to improve the 3-year OS compared to the other common treatments for ARM. Neo-IT + RS can be considered a valuable treatment since prospective trials are challenging for rare diseases. When RS is not feasible, Neo-IT + LS may be beneficial as the 3-year OS reaches 61%.</p>\",\"PeriodicalId\":15895,\"journal\":{\"name\":\"Journal of Gastrointestinal Cancer\",\"volume\":\"56 1\",\"pages\":\"108\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastrointestinal Cancer\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12029-025-01234-8\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01234-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：直肠肛管黑色素瘤（ARM）由于其5年总生存率（OS）低于20%且发病率不断上升，代表了一个有问题的情况。由于其可比较的OS，局部手术（LS）已取代根治性手术（RS）。辅助化疗（Adj-CHT）和辅助免疫治疗（Adj-IT）是ARM的常用治疗方法，而新辅助免疫治疗（Neo-IT）尚未研究。本研究旨在确定改善OS的最佳治疗方法。方法：纳入国家癌症数据库（2011-2021）中接受手术并接受Neo-IT、adjit或Adj-CHT治疗的非转移性ARM患者。根据手术入路（LS或RS）创建两个队列。在各自的队列中，根据年龄、肿瘤大小和位置、淋巴血管侵袭和淋巴结疾病，接受Neo-IT、adjit或adjj - cht治疗的患者按1:1:1匹配。Kaplan-Meier分析比较了不同组对3年OS的影响。结果：60例患者被纳入LS队列。其中，Kaplan-Meier分析的3年OS无差异（Neo-IT 61%, ji - it 47.1%, ji - cht 44%）。36例患者被纳入RS队列。Kaplan-Meier分析显示，Neo-IT是3年OS的保护因素(Neo-IT 71%, ad - it 11%, ad - cht 8%；p值= 0.002)。结论：与其他常见治疗方法相比，Neo-IT + RS似乎改善了3年OS。Neo-IT + RS可以被认为是一种有价值的治疗方法，因为罕见病的前瞻性试验具有挑战性。当RS不可行时，Neo-IT + LS可能是有益的，因为3年OS达到61%。
Multidisciplinary Management of Anorectal Melanoma: a Retrospective Analysis of Surgical and Systemic Therapies from the National Cancer Database.
Purpose: Anorectal melanoma (ARM) represents a problematic scenario due to a 5-year overall survival (OS) rate below 20% and its increasing incidence. Due to its comparable OS, local surgery (LS) has replaced radical surgery (RS). Adjuvant chemotherapy (Adj-CHT) and adjuvant immunotherapy (Adj-IT) are common treatments for ARM, while neoadjuvant immunotherapy (Neo-IT) has not been investigated yet. This study aimed to determine the best treatment to improve the OS.
Methods: Patients with non-metastatic ARM in the National Cancer 1Database (2011-2021) who underwent surgery and received Neo-IT, Adj-IT, or Adj-CHT were included. Two cohorts were created based on the surgical approach (LS or RS). In their respective cohorts, patients receiving Neo-IT, Adj-IT, or Adj-CHT were matched 1:1:1 based on age, tumor size and location, lymphovascular invasion, and nodal disease. Kaplan-Meier analyses compared the different groups' influence on the 3-year OS.
Results: Sixty patients were included in the LS cohort. Among them, there was no difference in the 3-year OS at the Kaplan-Meier analysis (Neo-IT 61%, Adj-IT 47.1%, and Adj-CHT 44%). Thirty-six patients were included in the RS cohort. Kaplan-Meier analysis for this group revealed that Neo-IT was a protective factor for 3-year OS (Neo-IT 71%, Adj-IT 11%, Adj-CHT 8%; p-value = 0.002).
Conclusion: Neo-IT + RS seems to improve the 3-year OS compared to the other common treatments for ARM. Neo-IT + RS can be considered a valuable treatment since prospective trials are challenging for rare diseases. When RS is not feasible, Neo-IT + LS may be beneficial as the 3-year OS reaches 61%.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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