Melanoma of the Vulva and Vagina: Surgical Management and Outcomes Based on a Clinicopathologic Reviewof 68 Cases

Sinasac, Sarah; Petrella, Teresa M.; Rouzbahman, Marjan; Sade, Shachar; Ghazarian, Danny; Vicus, Danielle

doi:10.1016/j.jogc.2018.07.011

Cited by 29 publications

(33 citation statements)

References 21 publications

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“…The literature on female genital melanoma is scarce; to date, there is only one prospective study following 71 women with VuM who underwent radical (hemi-)vulvectomy [9]. Retrospective series suggest that the prognosis and survival are significantly worse compared with cutaneous melanoma [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Malignant Melanoma of the Vulva and Vagina: A US Population-Based Study of 1863 Patients

et al. 2019

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Background Vulvar melanoma (VuM) and vaginal melanoma (VaM) represent a unique subgroup of malignant melanomas with important differences in biology and treatment. Objective The objective of this study was to describe the epidemiology and prognosis of VuM and VaM in a large representative cohort. Methods Women with invasive VuM or VaM were identified from the Surveillance, Epidemiology and End Results-18 population representing 27.8% of the US population. Data on age, ethnicity, stage, location, histopathology, primary surgery, and lymphadenectomy were collected. The Kaplan-Meier method was used to analyze disease-specific and overall survival. Univariate and multivariate regression models were used to identify factors with a significant association with disease-specific survival. Results A total of 1400 VuM and 463 VaM were included for further analysis; 78.6% and 49.7% of women with VuM and VaM underwent surgery, but only 52.9% of women with non-metastatic VuM and 42.9% of women with non-metastatic VaM undergoing surgery had lymph node assessment; one third of these had positive nodes. Superficial spreading was the most common subtype in VuM, and nodular melanoma in VaM (p < 0.001). The median disease-specific survival was 99 months (95% confidence interval 60-138) and 19 months (95% confidence interval 16-22), respectively. Survival was significantly associated with age at diagnosis, ethnicity, stage, surgery, lymph node metastases, histologic subtype, ulceration, mitotic count, and tumor thickness in VuM, and stage, surgery, and lymph node involvement in VaM. In the Cox model, lymph node status and number of mitoses remained independent predictors of outcome in VuM; in VaM, only lymph node status remained significant. Conclusions The overall prognosis of VuM and VaM remains poor. The American Joint Committee on Cancer staging system is applicable and should be used for VuM; however, lymph node status and mitotic rate are the most important predictors of survival. Lymph node status should be assessed and patients with positive nodes may be candidates for adjuvant treatment.

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Section: Introductionmentioning

confidence: 99%

Malignant Melanoma of the Vulva and Vagina: A US Population-Based Study of 1863 Patients

et al. 2019

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“…2 CD), as was shown by others. [7] A possible explanation for this is the increased local recurrence risk with involved margins, which may not affect the risk for distant recurrence. Importantly, histological margins of ≥ 10 mm were not statistically associated with better OS and RFS compared to margins <10 mm (Table 4, Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The most common tumour types were superficial spreading melanoma (SSM) (n = 73; 36.9%) and nodular malignant (NM) melanoma (n = 71; 35.9%). The median tumour thickness was 7 mm (IQR [3][4][5][6][7][8][9][10][11][12][13][14] and the median tumour size 20 mm (IQR 10-30). Ulceration and mitosis were present in 132 (66.7%) and 120 (60.7%) of the cases.…”

Section: Patients and Tumour Characteristicsmentioning

confidence: 99%

“…[5] Most women diagnosed with VM are postmenopausal and presentation is usually delayed due to the anatomic location which contributes to the poor prognosis. [5,7] Surgical treatment in the vulvar area and a high risk of recurrent disease present major clinical challenges in the treatment of patients with VM. [8] Clinical guidelines for VM have been based on evidence and recommendations for CM.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of treatment, prognostic factors, and survival in 198 vulvar melanoma patients: Implications for clinical practice

Boer

Eikelder

Geloven

et al. 2021

Gynecologic Oncology

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Vulvar melanoma is a rare gynaecological cancer with poor prognosis due to its high metastatic potential. • The only potentially curative option for localized disease is complete surgical resection with negative margins. • Sentinel lymph node biopsy is only recommended in order to direct adjuvant treatment. • Analysis for targetable mutations should be incorporated into routine clinical testing for vulvar melanoma. • Immunotherapy with anti-PD1 or anti-CTLA4 should be considered in metastatic or non-resectable vulvar melanoma.

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“…Таким образом, хирургический объем лечения меланомы вульвы и влагалища зависит от объема образования, размера опухоли, глубины инвазии. Радикально может быть выполнено широкое иссечение опухоли в пределах здоровой ткани, тотальная вульвэктомия или вагинэктомия, или гистерэктомия с вагинэктомией и вульвэктомией, или экзентерация таза в зависимости от локализации опухоли [11,23,39,40]. Пациентки, получившие хирургическое лечение, имели значительно более длительную общую выживаемость, в отличие от тех, кто не получал хирургическое лечение [13,22].…”

Section: лечениеunclassified

Melanoma of the lower female genital tract (vulva, vagina, and cervix): literature review and own cases

Сафронова

Артемьева

Нюганен

et al. 2019

Opuholi ženskoj reproduktivnoj sistemy

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Melanoma of the Vulva and Vagina: Surgical Management and Outcomes Based on a Clinicopathologic Reviewof 68 Cases

Cited by 29 publications

References 21 publications

Malignant Melanoma of the Vulva and Vagina: A US Population-Based Study of 1863 Patients

Malignant Melanoma of the Vulva and Vagina: A US Population-Based Study of 1863 Patients

Evaluation of treatment, prognostic factors, and survival in 198 vulvar melanoma patients: Implications for clinical practice

Melanoma of the lower female genital tract (vulva, vagina, and cervix): literature review and own cases

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