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<p>Anorectal malignant melanoma (ARMM), originating from melanocytes in the anorectal mucosa, is a rare but highly aggressive tumor characterized by early metastasis and poor prognosis, with a 5-year survival rate of 20.5%–33.3%. Limited by small-scale retrospective studies, prognostic factors and staging systems remain insufficiently defined. This study was conducted to address these gaps using data from the Surveillance, Epidemiology, and End Results (SEER) database. To construct a prognostic nomogram for patients with ARMM and improve individualized treatment strategies through quantitative outcome prediction. A retrospective analysis of 412 patientswith ARMM (2000–2021) from the SEER database was conducted. Clinicopathological variables, including age, tumor stage, size, surgery, were analyzed via univariate and multivariate Cox regression. A nomogram was developed based on independent prognostic factors and validated using discrimination (C-index) and calibration curves and by decision curve analysis. Independent prognostic factors included older age, advanced tumor stage (II/III), larger size (&gt;25 mm), lack of surgery. The nomogram demonstrated robust predictive performance (C-index: training cohort, 0.733; validation cohort, 0.728) with good calibration. Survival outcomes significantly worsened with advanced stages, with 5-year cancer-specific survival rates of 34.3%, 17.5%, and 12.5% for stage I–III, respectively). The nomogram offers reliable prognostic stratification for patients with ARMM to support clinical decision-making. However, limitations include potential selection bias, absence of molecular data (e.g., BRAF mutations), and lack of targeted/immunotherapy information. Future studies should refine staging systems and incorporate modern therapeutic advances.</p>

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Prognostic Risk Factors and Construction of a Survival Prognostic Model for Anorectal Malignant Melanoma Based on the Surveillance, Epidemiology, and End Results Database

  • 期刊论文

  • 发表日期：

    2026年4月22日

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  • Jingchao Wang,
  • Yi Bai,
  • Fengqin Xu,
  • Bochao Zhao,
  • Yuanfei Shan,
  • Zhijun Tan,
  • Yamin Zhang

摘要

Anorectal malignant melanoma (ARMM), originating from melanocytes in the anorectal mucosa, is a rare but highly aggressive tumor characterized by early metastasis and poor prognosis, with a 5-year survival rate of 20.5%–33.3%. Limited by small-scale retrospective studies, prognostic factors and staging systems remain insufficiently defined. This study was conducted to address these gaps using data from the Surveillance, Epidemiology, and End Results (SEER) database. To construct a prognostic nomogram for patients with ARMM and improve individualized treatment strategies through quantitative outcome prediction. A retrospective analysis of 412 patientswith ARMM (2000–2021) from the SEER database was conducted. Clinicopathological variables, including age, tumor stage, size, surgery, were analyzed via univariate and multivariate Cox regression. A nomogram was developed based on independent prognostic factors and validated using discrimination (C-index) and calibration curves and by decision curve analysis. Independent prognostic factors included older age, advanced tumor stage (II/III), larger size (>25 mm), lack of surgery. The nomogram demonstrated robust predictive performance (C-index: training cohort, 0.733; validation cohort, 0.728) with good calibration. Survival outcomes significantly worsened with advanced stages, with 5-year cancer-specific survival rates of 34.3%, 17.5%, and 12.5% for stage I–III, respectively). The nomogram offers reliable prognostic stratification for patients with ARMM to support clinical decision-making. However, limitations include potential selection bias, absence of molecular data (e.g., BRAF mutations), and lack of targeted/immunotherapy information. Future studies should refine staging systems and incorporate modern therapeutic advances.