ABSTRACT
Objective:To investigate the impact of the clinicopathological characteristics of anorectal malignant melanoma (ARMM) on the prognosis.Methods:The clinicopathological data of 40 ARMM patients undergoing surgery at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from Apr 2012 to Apr 2022 were collected, and the impact of different clinicopathological factors and treatment modalities on the overall survival of ARMM patients was investigated using Kaplan-Meier survival analysis and multifactorial Cox proportional risk model analysis.Results:Among 40 ARMM patients , 16 were male and 24 were female. The median age of onset was 61 yr. The median follow-up period for all patients was 47 (25-69) months, with a median survival of 19 (15-23) months and 1-year and 3-year survival rates of 74.3% and 21.7%, respectively. There was no statistically significant difference in survival time between the two groups of patients receiving wide local excision and abdominoperineal resection( χ2=1.281, P=0.258). Univariate analysis showed that overall survival in patients with ARMM was related to tumour diameter, depth of infiltration, specimen margin and lymph node metastasis ( χ2=1.281, P=0.039; χ2=3.760, P=0.042; χ2=6.581, P=0.010; χ2=21.683, P<0.001), and multivariate analysis suggested that lymph node metastasis was an independent risk factor for overall survival in patients with ARMM. Conclusion:Tumour diameter, depth of infiltration, specimen margin and lymph node metastasis were important prognostic influences in ARMM, and lymph node metastasis was an independent risk factor for overall survival in ARMM patients.
ABSTRACT
The death rate of colorectal cancer (CRC) is the fourth in worldwide. It is an important cause of cancer-related death and seriously affects the survival and quality of life of patients. Surgery, chemotherapy and radiotherapy are the main treatments for CRC. However, the overall survival of CRC patients has not been significantly improved. So the new treatments are urgently needed. Tumor immune escape plays a key role in tumor proliferation, recurrence and metastasis. Immune checkpoints programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) play an important role in tumor immune escape. Anti-PD-1/PD-L1 therapy has become a hotspot in cancer research. More and more studies have showed anti-PD-1/PD-L1 immunotherapy has achieved remarkable efficacy in the treatment of microsatellite instability-high (MSI-H) CRC. Therefore, this paper summarizes the clinical application of anti-PD-1/PD-L1 therapy in the treatment of CRC and the various strategies to improve its low response rate. And the predictive value of PD-L1 expression on the surface of tumor cells in the prognosis of CRC is also reviewed.
