Management of Malignant Vulval Melanoma: A Retrospective Case Series and Review of the Literature.

Management of Malignant Vulval Melanoma: A Retrospective Case Series and Review of the Literature.

Publication date: Mar 20, 2020

The aims of the study were to evaluate clinicopathologic features, management, and outcomes in vulval melanoma and to review the literature.

Data were collected retrospectively on patients with vulval melanoma from 2001 to 2017 in 5 gynecological oncology cancer centers (Bristol, Taunton, Truro, Plymouth, and Cheltenham). SPSS software was used for univariate and multivariate statistical analysis. Disease-specific median survival was calculated using Kaplan-Meier curves.

Forty-four patients with vulval melanoma were included, with a median age of 71 years. Forty-three of 44 had wide local excision with full inguinal lymphadenectomy if abnormal lymph nodes. Seven patients had sentinel lymph nodes. However, 2 patients with negative sentinel lymph nodes had distant recurrences within 16 months.On univariate analysis, presence of ulceration (p = .012), perineural invasion (p = .03), and area of lesion (p = .016) were associated with risk of recurrence but only presence of microsatellites (p = .01) was associated with risk of death.There were 31 deaths (70%): 29 (94%) of 31 from melanoma and 28 (64%) of 44 recurrences: 17 local (10 groin, 7 vulval) and 9 distant. Overall median survival was 32.5 months (95% CI, 17.8-46.5 months) and median recurrence-free survival 12.6 months (95% CI, 7.7-17.4 months).

This retrospective multicenter study highlights the high recurrence rate and poor prognosis of vulval melanoma. Lymph node surgery did not make any difference to recurrence-free survival or overall survival. The presence of microsatellites was associated with a statistically increased risk of death.

Platt, S., Coleridge, S., Hughes, G., Donkers, H., Wiggans, A., Frost, J., Rolland, P., Julian, S., Morrison, J., Pawade, J., Patel, A., and Newton, C. Management of Malignant Vulval Melanoma: A Retrospective Case Series and Review of the Literature. 26214. 2020 J Low Genit Tract Dis.

Concepts Keywords
Bristol Retrospectively vulval melanoma
Cheltenham Surgery
Gynecological Medicine
Inguinal Medical specialties
Lesion RTT
Lymph Node Clinical medicine
Lymph Nodes Cancer
Lymphadenectomy Melanoma
Malignant Sentinel lymph node
Melanoma Lymphadenectomy
Microsatellites Vulva
Multivariate Vulvar cancer
Plymouth
Prognosis
Sentinel Lymph Nodes
SPSS
Taunton
Truro
Ulceration
Univariate

Semantics

Type Source Name
disease MESH Melanoma
pathway KEGG Melanoma
disease MESH cancer
disease MESH recurrences
disease MESH death

Original Article

Leave a Comment

Your email address will not be published. Required fields are marked *