Abstract
Background: The aim of this study was to evaluate the prognostic significance of clinicalpathologic variables in melanoma of the vulva.
Methods: From 1979 through 1995, 40 women with a diagnosis of vulvar melanoma underwent radical surgery. Patient age, tumor size and site, histologic type, ulceration, tumor thickness, lymph node status, and number of positive lymph nodes were assessed for prognostic significance by multivariate analysis.
Results: Tumor thickness was a significant predictor of lymph node involvement, but not of survival. The most powerful predictors of survival by multivariate analysis were the lymph node status (P 5 .002) and the number of positive lymph nodes (P 5 .00003).
Conclusions: The number of positive lymph nodes represents the strongest prognostic factor in melanoma of the vulva. Because of the lack of effective adjuvant therapies, such prognostic indicators might be used to define the timing and extent of the surgical approach.
Article PDF
Avoid common mistakes on your manuscript.
References
Ragnarsson-Olding B, Johansson H, Rutqvist LE, Rinborg U. Malignant melanoma of the vulva and vagina. Trends in incidence, age distribution, and long-term survival among 245 consecutive cases in Sweden 1960–1984. Cancer 1993;71:1983–1987.
Weinstock MA. Malignant melanoma of the vulva and vagina in the United States: patterns of incidence and population-based estimates of survival. Am J Obstet Gynecol 1994;171:1225–1230.
Phillips GL, Twiggs LB, Okagaki T. Vulvar melanoma: a microstaging study. Gynecol Oncol 1982;14:80–88.
Podratz KC, Gaffey TA, Symmonds RE, Johanssen KL, Ò Brien PC. Melanoma of the vulva. An update. Gynecol Oncol 1983;16:153–68.
Piura B, Egan M, Lopes A, Monaghan J. Malignant melanoma of the vulva: a clinicopathologic study of 18 cases. J Surg Oncol 1992;50:234–240.
Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970;172:902–908.
Beller U, Demopulos RI, Beckman EM. Vulvo-vaginal melanoma: a clinico-pathologic study. J Reprod Med 1986;31:315–319.
Scheistroen M, Tropè C, Kaern J, Abeler VM, Petterssen EO, Kristensen GB. Malignant melanoma of the vulva: evaluation of prognostic factors with emphasis on DNA ploidy in 75 patients. Cancer 1995;75:72–80.
Johnson TL, Kumar NB, White CD, Morley GW. Prognostic features of vulvar melanoma: a clinico-pathologic analysis. Int J Gynecol Pathol 1986;5:110–118.
Tasseron EWK, Esch EPvan der, Hart AAM, Brutel da la Riviere G, Aartsen EJ. A clinico-pathological study of 30 melanomas of the vulva. Gynecol Oncol 1992;46:170–175.
Aitkin DR, Clausen K, Klein. The extent of primary melanoma excision —A re-evaluation —How wide is wide? Ann Surg 1983;198:634–641.
Rose PG, Piver MS, Tsukada Y, Lau T. Conservative therapy for melanoma of the vulva. Am J Obstet Gynecol 1988;159:52–55.
Trimble EL, Lewis JL Jr, Williams LL, et al. Management of vulvar melanoma. Gynecol Oncol 1992;45:254–258.
Peto R, Pike MC, Armitage P. Design and analysis of randomised clinical trials requiring prolonged observation of each patient. II. Analysis and examples. Br J Cancer 1977;35:1–39.
Cox DR. Regression models and life tables. J R Statist Soc Bull 1972;34:187–220.
Kirkwood JM, Strawderman MH, Ernstoff MS, Smith TJ, Borden EC, Blum RH. Interferon alfa 2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial Est. J Clin Oncol 1996;14:7–17.
Piura B, Meirovtz M, Kedar I. Long-term disease-free survival following surgery and active specific immunotherapy with allogenic vaccine in a patient with high-risk malignant melanoma of the vulva. Eur J Obstet Gynecol Reprod Biol 1998;81:83–85.
Morton DL, Wen D, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392–399.
Bradgate MG, Rollanson TP, McConkey CC, Powell J. Malignant melanoma of the vulva: a clinico-pathological study of 50 women. Br J Obstet Gynecol 1990;97:124–133.
Stefanon B, Clemente C, Lupi G, et al. Malignant melanoma of the vulva: a clinico-pathologic study of 28 cases. Cervix 1987;5:223–227.
Phillips LG, Bundy BN, Okagaki T, Kucera PR, Stehaman FB. Malignant melanoma of the vulva treated by radical hemivulvectomy. Cancer 1994;73:2626–2632.
Ragnarsson-Olding B, Kanter-Lewensonhn LR, Lagerlof B, Nilsson BR, Rinborg UK. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females: clinical observations and histopathologic features. Cancer 1999;86:1273–1284.
Veronesi U, Adamus J, Bandiera DC, et al. Inefficacy of immediate lymph node dissection in stage I melanoma of the limbs. N Engl J Med 1977;297:627–630.
Veronesi U, Adamus J. Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities. Cancer 1982;49:2420–2430.
Sim FH, Taylor WF, Ivins JC, Pritchard DJ, Soule EH. A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma: preliminary results. Cancer 1978;41:948–956.
Cicco CDe, Sideri M, Bartolomei B, et al. Sentinel node biopsy in early vulvar cancer. Br J Cancer 2000;82:295–299.
Terada KY, Shimizu DM, Wong JH. Sentinel node dissection and ultrastaging in squamous cell cancer of the vulva. Gynecol Oncol 2000;76:40–44.
Ansink AC, Sie-Go DMDS, Velden Jvan der, et al. Identification of sentinel lymph nodes in vulvar carcinoma patients with the aid of a patent blue V injection. Cancer 1999;86:652–656.
Valdes Olmos RA, Jansen L, Muller SH, Hoefnagel CA, Nieweg O. Contribution of nuclear medicine to lymphatic mapping and sentinel node identification in oncology. Rev Esp Med Nucl 1999;118:111–121.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Raspagliesi, F., Ditto, A., Paladini, D. et al. Prognostic Indicators in Melanoma of the Vulva. Ann Surg Oncol 7, 738–742 (2000). https://doi.org/10.1007/s10434-000-0738-x
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10434-000-0738-x