Surgical Management and Prognostic Factors of Vulvovaginal Melanoma

Antonino Ditto, Giorgio Bogani, Fabio Martinelli, Violante Di Donato, Joel Laufer, Santiago Scasso, Valentina Chiappa, Mauro Signorelli, Alice Indini, Domenica Lorusso, Francesco Raspagliesi

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: The aim of the study was to evaluate the surgical management and the role of different prognostic factors on survival outcomes of women affected by genital (i.e., vulvar and vaginal) melanoma. MATERIALS AND METHODS: Data of patients undergoing primary surgical treatment for genital melanoma were evaluated in this retrospective study. Baseline, pathological, and postoperative variables were tested to identify prognostic factors. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier and Cox proportional hazards models. RESULTS: Overall, 98 patients met the inclusion criteria. Sixty-seven (68%) and 31 (32%) patients in this study population were diagnosed with vulvar and vaginal melanoma, respectively. Median (range) DFS and OS were 12 (1–70) and 22 (1–70) months, respectively. Considering factors influencing DFS, we observed that at multivariate analysis, only vaginal localization (hazard ratio [HR] = 3.72; 95% CI = 1.05–13.2) and number of mitoses (HR = 1.24; 95% CI = 1.11–1.39) proved to be associated with worse DFS. Nodal status was the only independent factor influencing 5-year OS in patients with vulvar (HR = 1.76; 95% CI = 1.22–2.54; p = .002) and vaginal (HR = 3.65; 95% CI = 1.08–12.3; p = .03) melanoma. CONCLUSIONS: Genital melanomas are characterized by a poor prognosis. Number of mitoses and lymph node status are the main factors influencing survival. Surgery is the mainstay of treatment. A correct and prompt diagnosis is paramount.

Original languageEnglish
JournalJournal of Lower Genital Tract Disease
DOIs
Publication statusAccepted/In press - Mar 30 2016

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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