Different clinico-pathological and prognostic features of vulvar, vaginal, and cervical melanomas

Wu, Y; Lai, Yisheng; Li, Huan; Tan, Luxin; Li, Zhongwu

doi:10.1016/j.humpath.2022.11.002

Cited by 9 publications

(5 citation statements)

References 36 publications

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“…We found that MM of the female genital tract and the head and neck more often present with localised disease, corresponding with higher survival rates compared with other locations of MM. Within MM of the female genital tract, the better prognosis of vulvar MM compared to vaginal MM is in line with the literature [26,27]. Vulvar and vaginal MM are often classified as one entity.…”

Section: Discussionsupporting

confidence: 80%

“…MM originating from cutaneous and not mucosal lining and a more visible location allow vulvar MM to be diagnosed at an earlier stage than vaginal MM, which may contribute to a better prognosis. Moreover, a mutational analysis of 95 female genital tract melanomas showed that BRAF mutation, which is often found in CM, is more often detected in vulvar MM compared with vaginal MM, respectively, in 28% and 9% of cases [26]. These data suggest that MM located at the vulva may even have more resemblance to CM than with MM and that immune and targeted therapy may likewise be promising for advanced disease.…”

Section: Discussionmentioning

confidence: 95%

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Trends in Incidence and Survival of 1496 Patients with Mucosal Melanoma in The Netherlands (1990–2019)

Boer

Louwman

et al. 2023

Cancers

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Background: Mucosal melanoma (MM) is a rare tumour with a poor prognosis. Over the years, immune and targeted therapy have become available and have improved overall survival (OS) for patients with advanced cutaneous melanoma (CM). This study aimed to assess trends in the incidence and survival of MM in the Netherlands against the background of new effective treatments that became available for advanced melanoma. Methods: We obtained information on patients diagnosed with MM during 1990–2019 from the Netherlands Cancer Registry. The age-standardized incidence rate and estimated annual percentage change (EAPC) were calculated over the total study period. OS was calculated using the Kaplan–Meier method. Independent predictors for OS were assessed by applying multivariable Cox proportional hazards regression models. Results: In total, 1496 patients were diagnosed with MM during 1990–2019, mostly in the female genital tract (43%) and the head and neck region (34%). The majority presented with local or locally advanced disease (66%). The incidence remained stable over time (EAPC 3.0%, p = 0.4). The 5-year OS was 24% (95%CI: 21.6–26.0%) with a median OS of 1.7 years (95%CI: 1.6–1.8). Age ≥70 years at diagnosis, higher stage at diagnosis, and respiratory tract location were independent predictors for worse OS. Diagnosis in the period 2014–2019, MM located in the female genital tract, and treatment with immune or targeted therapy were independent predictors for better OS. Conclusion: Since the introduction of immune and targeted therapies, OS has improved for patients with MM. However, the prognosis of MM patients is still lower compared to CM, and the median OS of patients treated with immune and targeted therapies remains fairly short. Further studies are needed to improve outcomes for patients with MM.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 95%

Trends in Incidence and Survival of 1496 Patients with Mucosal Melanoma in The Netherlands (1990–2019)

Boer

Louwman

et al. 2023

Cancers

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“…The result suggested enhanced anti-fungal and encapsulation efficiency of MCZ in comparison to marketed products. Also, the microsponges showed better drug retention in the vagina due to bioadhesion [46] .…”

Section: Pre-clinical Case Reportmentioning

confidence: 98%

“…The female reproductive consists of ovaries, fallopian tubes, uterus, vagina, vulva, accessory glands, and external genital organs. Out of which vagina is the flexible, fibromuscular tube measuring 6 to 8 cm in length crucial connecting vulva with the cervix of the uterus and then to the uterine cavity [46] . The vaginal opening is situated in the posterior portion of the vulvar vestibule, at the back of the urethral opening.…”

Section: Vaginal Pathophysiologymentioning

confidence: 99%

Advancements in microsponges for the management of vaginal and colorectal diseases: A comprehensive review

Rathi,

Kaur,

Chopra

et al. 2024

Appl. Chem. Eng.

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The controlled-release drug delivery systems have risen dramatically allowing various factors such as the prohibitive cost of developing new entities, the expiration of existing international patents, and the discovery of new polymeric materials suitable for prolonged drug release and improvement in therapeutic efficacy. Microsponges are the porous microspheres-based polymeric delivery system that allows controlled drug release at a specific site. Microsponges are developed for the efficient delivery of active ingredients at a low dose. They help in improving stability by modifying drug release kinetics, reducing side effects, and enhancing the retention of drug entities. Microsponge compositions are stable throughout a wide pH and temperature range, making them more compatible with numerous vehicles, and ingredients. Several studies have shown that microsponges are non-irritant, non-toxic, non-mutagenic, and non-allergic with self-sterilizing properties. They are typically used for topical administration but have lately been used for oral, vaginal, and colorectal administration as well. The current review contains basic information about microsponges, their method of preparation, and various characterization parameters. The review also discusses the application of microsponges in vaginal and colorectal diseases. The latter portion of the script includes various patents and preclinical trials.

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“…Furthermore, diagnosis occurs more frequently in the advanced stages of the disease, with a reduced probability of surgical radicality and a higher risk of severe sequelae. However, combined approaches with adjuvant radiotherapy have resulted in very poor outcomes due to the high rates of local and distant recurrences [3].…”

Section: Introductionmentioning

confidence: 99%

The Role of Radiotherapy in the Management of Vaginal Melanoma: A Literature Review with a Focus on the Potential Synergistic Role of Immunotherapy

Cuccia

D'Alessandro

Blasi³

et al. 2023

JPM

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Among the mucosal melanomas, vaginal melanomas are very rare tumors, accounting for less than 20% of melanomas arising from the female genital tract. They occur most frequently in women in post-menopausal age, but younger patients may also experience this neoplasm, mainly located in the lower third of the vagina or the anterior wall. The optimal management of this tumor remains controversial, with surgery reported as the most frequently adopted approach. However, a clear benefit of surgical treatment in terms of survival has not yet been demonstrated. Conversely, radiotherapy may represent an attractive non-invasive alternative, and there are several favorable reports of the role of radiation therapy, either delivered with photons, brachytherapy, or hadrontherapy. A wide range of techniques and fractionation regimens are reported with substantially good tolerance to the treatment, and acute G3 or higher toxicities are reported only in the case of concurrent immunotherapy. Of note, due to the rarity of the disease, there is a lack of high-level evidence for the optimal therapeutic option. In this scenario, recent studies theorize the possibility of developing combinatorial approaches of radiotherapy with immunotherapy based on cutaneous melanomas reports. In this review, we aim to summarize the evidence available in the literature supporting the role of definitive radiotherapy for vaginal melanomas, with a focus on the combination of RT with immunotherapy, in terms of optimal timing and biological rationale.

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Different clinico-pathological and prognostic features of vulvar, vaginal, and cervical melanomas

Cited by 9 publications

References 36 publications

Trends in Incidence and Survival of 1496 Patients with Mucosal Melanoma in The Netherlands (1990–2019)

Trends in Incidence and Survival of 1496 Patients with Mucosal Melanoma in The Netherlands (1990–2019)

Advancements in microsponges for the management of vaginal and colorectal diseases: A comprehensive review

The Role of Radiotherapy in the Management of Vaginal Melanoma: A Literature Review with a Focus on the Potential Synergistic Role of Immunotherapy

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