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1% 5-year survival for local excision, median 17 months versus 8.7% 5-year survival, median 14 months for extensive resection (p=0.741)). Stage and date of diagnosis showed to be prognostic factors of survival. The ratio between the two surgical approaches was unchanged over three decades. Extensive resection does not seem to improve survival in both cN0 and cN+anorectal melanoma patients compared to local excision. However in the past three decades no shift towards local excision has been found. cN+stage and an older date of diagnosis