Staging Classification of Falch et al for Anorectal Malignant Melanoma (ARMM)

Description

Falch et al proposed a staging classification for patients with anorectal malignant melanoma (ARMM). This can be helpful in determining prognosis and for management planning. The authors are from multiple universities in Europe, the United States and Israel.

Patient selection: anorectal malignant melanoma (excluding cutaneous melanoma of perianal skin)

Most anorectal melanomas occur on or near the pectinate line.

Staging is performed based on:

(1) clinical assessment

(2) histology

(3) PET scan

(4) transrectal ultrasound (TRUS)

(5) pelvic MRI

(6) sentinel lymph node mapping (using the double-tracer technique)

(7) examination of organs for distant metastases (especially bone, liver and lung)

Parameters:

(1) invasion of muscularis propria

(2) regional spread

(3) lymph node metastases

(4) distant metastases

Muscularis Propria	Regional Spread	Lymph Node Metastases	Distant	Stage
negative	absent	negative	negative	I
invasion	absent	negative	negative	II
invasion	present	NA	negative	III
invasion	NA	positive	negative	III
NA	NA	NA	NA	IV

In theory there should be an in situ stage if there is no invasion.

Stage	Management (Figure 1)
I	abdomino-perineal resection
II	wide local excision with adjuvant radiation therapy OR palliative abdomino-perineal resection
III	wide local excision with adjuvant radiation therapy
IV	wide local excision with adjuvant radiation therapy OR palliative abdomino-perineal resection

To read more or access our algorithms and calculators, please log in or register.

Staging Classification of Falch et al for Anorectal Malignant Melanoma (ARMM)

Description

Specialty