{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:36:35Z","timestamp":1771061795850,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T00:00:00Z","timestamp":1486080000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Primary anorectal melanoma is a rare disease with a dismal prognosis due to early distant metastasis. The prognostic value of positive loco\u2010regional lymph nodes and the impact of lymphadenectomy on overall survival are unclear. We have investigated this by analysis of data obtained from a national representative database, controlling for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were retrieved from the Surveillance, Epidemiology and End Results (<jats:styled-content style=\"fixed-case\">SEER<\/jats:styled-content>) database. Multiple imputation analysis was performed to deal with missing data. Cox regression models were formulated using different prognostic factors including site of origin, gender, size, race, rate of lymph node metastasis (ratio between positive lymph node count and total lymph nodes harvested), extent of lymphadenectomy (none, level I etc.), age, type of surgery, stage of disease and administration of radiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our population was composed of 208 patients who underwent surgery between 1998 and 2012. Rate of lymph node metastasis (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.027; hazard ratio 1.873, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.076\u20133.261) and race (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.019; hazard ratio 2.291, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.148\u20134.575) were found to be independent predictors of survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the data retrieved from the <jats:styled-content style=\"fixed-case\">SEER<\/jats:styled-content> database, metastasis to loco\u2010regional lymph nodes is an important prognostic factor, but lymphadenectomy does not improve survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13412","type":"journal-article","created":{"date-parts":[[2016,6,18]],"date-time":"2016-06-18T08:27:06Z","timestamp":1466238426000},"page":"158-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Extensive surgery and lymphadenectomy do not improve survival in primary melanoma of the anorectum: results from analysis of a large database (<scp>SEER<\/scp>)"],"prefix":"10.1111","volume":"19","author":[{"given":"A.","family":"Ciarrocchi","sequence":"first","affiliation":[{"name":"General and Emergency Surgery University of L'Aquila L'Aquila Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Pietroletti","sequence":"additional","affiliation":[{"name":"Coloproctological Surgery University of L'Aquila Hospital Val Vibrata Sant'Omero (TE) Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Carlei","sequence":"additional","affiliation":[{"name":"Postgraduate School of Digestive Surgery University of L'Aquila L'Aquila Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Amicucci","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery University of L'Aquila L'Aquila Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02140894"},{"key":"e_1_2_8_3_1","unstructured":"Surveillance Epidemiology and End Results (SEER) Program (2002) Public Use Data (1973\u20131999) Cancer Statistics Branch Surveillance Research Program DCCPS.http:\/\/www.seer.cancer.gov(accessed November 2015)."},{"key":"e_1_2_8_4_1","unstructured":"The SEER Program Coding and Staging Manual 2004.http:\/\/seer.cancer.gov\/archive\/manuals\/2004Revision1\/SPM_2004_maindoc.r1.pdf(accessed November 2015)."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13362"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1988.10478722"},{"key":"e_1_2_8_7_1","volume-title":"Statistical Analysis with Missing Data. 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