The role of sentinel lymph node mapping in lower genital tract melanoma

Lopez, Salvatore; Guerrisi, Rocco; Brusadelli, Claudia; Bogani, Giorgio; Ditto, Antonino; Raspagliesi, Francesco

doi:10.23736/s0026-4784.20.04628-6

Cited by 4 publications

(5 citation statements)

References 55 publications

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“…A meta-analysis has shown that the detection rate using blue dye in combination with radiocolloid tracer is 97.7% (95% CI 96.6–98.5) if ultra-staging and immunohistochemistry is performed [ 62 ]. A similar detection rate of 98.3% has been reported in a literature review of VMs [ 63 ].…”

Section: Surgical Treatmentsupporting

confidence: 83%

Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment

Wohlmuth

Wohlmuth-Wieser

2021

Am J Clin Dermatol

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Ten percent of all women have pigmented vulvar lesions. Fortunately, most of these are benign but 1% of all melanomas in women affect the vulva. While the mortality rate of cutaneous melanoma has dropped by 7% annually during the last 5 years, the prognosis of vulvar melanoma remains dismal: the 5-year overall survival rate is 47% compared with 92% for cutaneous melanoma. The current evidence suggests that this likely results from a combination of delayed diagnosis and different tumor biology, treatment strategies, and treatment response. Although many landmark trials on checkpoint inhibitors included mucosal and vulvar melanomas, the results were often not reported separately. Post-hoc analyses indicate overall response rates between 19 and 37% for checkpoint inhibitors. A recently published retrospective study on vulvar melanomas suggests an objective response in 33.3% with a similar safety profile to cutaneous melanoma. Tyrosine kinase inhibitors may be considered in recurrent disease if a c-KIT mutation is present. Key PointsCompared with skin melanomas, vulvar melanomas are associated with a poor prognosis resulting from delayed diagnosis and different tumor biology, treatment strategies, and treatment response.Novel treatment modalities include checkpoint inhibitors and targeted therapies and recent evidence shows that these are also effective in vulvar melanomas.Vulvar melanomas have a different tumor biology with frequent c-KIT mutations, which provides an additional therapeutic target in recurrent disease.

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Section: Surgical Treatmentsupporting

confidence: 83%

Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment

Wohlmuth

Wohlmuth-Wieser

2021

Am J Clin Dermatol

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“…A small‐scale study of lymphatic mapping and SLN detection of vaginal cancer patients showed that at least one sentinel lymph node was identified in 79% of patients 25 . A recent review analyzed 132 patients with lower genital tract melanoma in 10 retrospective studies found that 63 (47%) patients underwent SLN with an average detection rate of 98.3%, and confirmed that SLN procedure was capable of identifying patients with occult lymph node metastases 26 . Montemorano et al.…”

Section: Sentinel Lymph Node Mappingmentioning

confidence: 92%

“…25 A recent review analyzed 132 patients with lower genital tract melanoma in 10 retrospective studies found that 63 (47%) patients underwent SLN with an average detection rate of 98.3%, and confirmed that SLN procedure was capable of identifying patients with occult lymph node metastases. 26 Montemorano et al successfully used ICG to perform SLN mapping in patients with single case squamous cell vaginal cancer. 27,28 By combining treatment with SLNB, we can determine the stage of the disease accurately, so as to avoid systemic lymph node dissection and further surgical treatment.…”

Section: Vaginal Cancermentioning

confidence: 99%

Research progress of indocyanine green fluorescence technology in gynecological applications

Li,

Zhang,

Fang

et al. 2023

Intl J Gynecology & Obste

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Indocyanine green is a near‐infrared fluorescent dye which is widely used in various fields of surgery and gynecology. It is currently mainly used to detect various malignant tumors, sentinel lymph nodes, endometriosis lesions, ureter or intestinal occlusion, vaginal perfusion, uterine arterial blood perfusion, pelvic nerve, uterine niche, lymphatic edema, metastatic lesion shadow, and so on, providing new methods for decision‐making during surgery. This article elaborates the application progress of indocyanine green fluorescence technology in gynecology.

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“…In cases of VaM with additional risk factors, resection of the lesion is difficult, and sentinel lymph node mapping is not performed [ 18 ]. According to a retrospective study by Lopez et al ., the sentinel lymph node procedure can identify occult lymph node metastases in patients with VuM and VaM; however, its clinical application needs to be validated further [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological demographics of malignant melanomas of the vulva and vagina in Japan

et al. 2023

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Malignant vulvar melanoma (VuM) and vaginal melanoma (VaM) represent a unique subgroup of rare malignant melanomas with critical biological properties that differ from other cancers. In Japan, adequate surveys have yet to be conducted. This study aimed to elucidate the clinicopathological demographics and outcomes of VuM and VaM in Japan. This retrospective observational study included women with invasive VuM or VaM identified from older medical records in Japan. We collected clinical data and used the Kaplan–Meier method to analyze progression-free survival (PFS) and overall survival (OS). Univariate and multivariate regression models were used to identify factors significantly related to survival. We identified 217 patients, 109 (50.2%) with VuM and 108 (49.8%) with VaM. The median PFS was 16.8 months in patients with VuM [95% confidence interval (CI), 23.1–87.7] and 15.6 months in those with VaM (95% CI, 8.4–12.6). The median OS was 43.9 months (95% CI, 60–138) and 31.1 months (95% CI, 24.8–45.3) in patients with VuM and VaM, respectively. Multivariate analysis showed that a disease stage higher than stage III, based on the American Joint Committee on Cancer (AJCC) guidelines, was associated with poorer PFS [hazard ratio (HR), 2.063; 95% CI, 0.995–4.278] and an unknown surgical margin was the only independent factor influencing OS (HR, 2.188; 95% CI, 1.203–3.977). The overall outcomes of invasive VuM and VaM in Japan remain poor. AJCC staging and surgical margins were significant predictors of survival.

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The role of sentinel lymph node mapping in lower genital tract melanoma

Cited by 4 publications

References 55 publications

Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment

Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment

Research progress of indocyanine green fluorescence technology in gynecological applications

Clinicopathological demographics of malignant melanomas of the vulva and vagina in Japan

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