Mucosal melanoma of the female genitalia

A clinicopathologic study of forty-three cases at Duke University Medical Center

P. DeMatos, Douglas Tyler, H. F. Seigler

Research output: Contribution to journalArticle

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Abstract

Background. Mucosal melanoma of the female genitalia is a rare neoplasm. Only nine reports reviewing more than 40 patients have been published on this subject in the past 30 years. These lesions arise from melanocytes, which can be found within the mucosa lining the female genital tract. Surgical resection is the mainstay of therapy, with little use for other modalities except in palliative roles. The overall prognosis is poor, with reported 5- year survival rates usually below 50%. Methods. Forty-three patients with primary mucosal melanoma of the female genitalia seen at the Duke University Medical Center Melanoma Clinic during a 25-year period were studied retrospectively. Specific information was obtained from the patients' clinic charts and computerized databases. Results. Thirty vulvar, nine vaginal, and four cervical lesions were identified. The median age at diagnosis was 61.4 years. At initial presentation, two thirds of the patients had localized disease only. Tumor ulceration and thickness of the primary lesion had a measurable impact on prognosis, whereas the presence of regional metastases at presentation did not. All but one patient underwent resection with curative intent. The performance of radical operations did not improve outcome among patients with vulvar melanoma. Many of the treatment failures were the result of local recurrences, hinting at the need to improve local control. Despite therapy, the overall corrected 5-year survival rate was 54%. Conclusions. Prospective multicenter trials for patients with vulvovaginal melanoma could be helpful in establishing uniform, standardized surgical protocols and delineating the applicability of new modalities and therapies, such as lymphoscintigraphy with sentinel node biopsy and high-dose interferon.

Original languageEnglish (US)
Pages (from-to)38-48
Number of pages11
JournalSurgery
Volume124
Issue number1
DOIs
StatePublished - 1998
Externally publishedYes

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Female Genitalia
Melanoma
Survival Rate
Lymphoscintigraphy
Melanocytes
Treatment Failure
Interferons
Multicenter Studies
Neoplasms
Mucous Membrane
Therapeutics
Databases
Neoplasm Metastasis
Biopsy
Recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

Mucosal melanoma of the female genitalia : A clinicopathologic study of forty-three cases at Duke University Medical Center. / DeMatos, P.; Tyler, Douglas; Seigler, H. F.

In: Surgery, Vol. 124, No. 1, 1998, p. 38-48.

Research output: Contribution to journalArticle

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abstract = "Background. Mucosal melanoma of the female genitalia is a rare neoplasm. Only nine reports reviewing more than 40 patients have been published on this subject in the past 30 years. These lesions arise from melanocytes, which can be found within the mucosa lining the female genital tract. Surgical resection is the mainstay of therapy, with little use for other modalities except in palliative roles. The overall prognosis is poor, with reported 5- year survival rates usually below 50{\%}. Methods. Forty-three patients with primary mucosal melanoma of the female genitalia seen at the Duke University Medical Center Melanoma Clinic during a 25-year period were studied retrospectively. Specific information was obtained from the patients' clinic charts and computerized databases. Results. Thirty vulvar, nine vaginal, and four cervical lesions were identified. The median age at diagnosis was 61.4 years. At initial presentation, two thirds of the patients had localized disease only. Tumor ulceration and thickness of the primary lesion had a measurable impact on prognosis, whereas the presence of regional metastases at presentation did not. All but one patient underwent resection with curative intent. The performance of radical operations did not improve outcome among patients with vulvar melanoma. Many of the treatment failures were the result of local recurrences, hinting at the need to improve local control. Despite therapy, the overall corrected 5-year survival rate was 54{\%}. Conclusions. Prospective multicenter trials for patients with vulvovaginal melanoma could be helpful in establishing uniform, standardized surgical protocols and delineating the applicability of new modalities and therapies, such as lymphoscintigraphy with sentinel node biopsy and high-dose interferon.",
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