Vulvar melanoma: management of primary disease and repeated recurrences

Barquet-Muñoz, Salim Abraham; Leitao, Mario M.; Montiel, Maria Delia Pérez; Concha, Bernardino Gabriel Santiago

doi:10.1136/ijgc-2019-000610

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…OS in this series shows no difference between the SLNB and lymphadenectomy group for any T [ 83 ]. SLNB should be bilateral if the primary disease is within 2 cm from the midline [ 84 ]. Completion of lymphadenectomy when SLN is positive is not determined for VM: MSLT-I and II trials show better survival and regional disease control for patients who underwent surgical completion after SLNB positivity [ 85 , 86 ].…”

Section: Resultsmentioning

confidence: 99%

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Vulvar Malignant Melanoma: A Narrative Review

Falcicchio

Vinci

Cicinelli

et al. 2022

Cancers

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Malignant melanoma is a fatal disease that affects all skin sites. Among these, vulvar melanoma (VM) is a rare gynecological condition that accounts for 5% of all vulvar neoplasms. VM primarily affects older Caucasian women and its relationship to sun exposure is undefined. Diagnosis is defined by biopsy but many clinical, dermatoscopic, and confocal microscopic features can guide doctors. The molecular profile is characterized by the KIT mutation, revealed by all of the technologies that are used (classical sequencing, next-generation sequencing, and immunohistochemical staining). BRAF and NRAS mutations are also common in VM. All of these mutations are possible therapeutic targets. Today, surgery remains the first treatment choice for primary VM. The role of neoadjuvant and adjuvant therapy is scarce and the treatment of relapses is widely debated.

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Section: Resultsmentioning

confidence: 99%

“…Dhar et al [ 88 ] reported a 15% false-negative rate of SLNB. Some authors consider close follow-up for positive SLN by clinical examination and ultrasound [ 62 , 84 ].…”

Section: Resultsmentioning

confidence: 99%

Vulvar Malignant Melanoma: A Narrative Review

Falcicchio

Vinci

Cicinelli

et al. 2022

Cancers

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Role of immunotherapy for lymph node positive vulvar melanoma: utilization and outcomes

Nasioudis,

Labban,

Latif

et al. 2023

Int J Gynecol Cancer

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ObjectiveTo investigate the utilization and outcomes of adjuvant immunotherapy for patients with vulvar melanoma and inguinal lymph node metastases.MethodsThe National Cancer Database was accessed and patients with vulvar melanoma diagnosed between 2004 and 2015 who did not have distant metastases, underwent inguinal lymphadenectomy, had positive lymph nodes, and at least 1 month of follow-up were identified. Administration of immunotherapy was evaluated and clinicopathological characteristics were compared. Median overall survival was compared with the log-rank test. Stratified analysis based on clinical status of lymph nodes was performed. A Cox model was constructed to evaluate survival after controlling for confounders.ResultsA total of 300 patients were identified; the rate of immunotherapy use was 25% (75 patients). Patients who received immunotherapy were younger (median 58 vs 70 years, p<0.001); however, the two groups were comparable in terms of clinical lymph node status, rate of positive tumor margins, presence of tumor ulceration, tumor size, Breslow thickness, and performance of comprehensive lymphadenectomy. There was no overall survival difference between patients who did (median 31.08 months) and did not (median 22.77 months) receive immunotherapy (p=0.18). Following stratification by clinical lymph node status, immunotherapy did not improve overall survival of patients with clinically negative (median 35.35 vs 33.22, p=0.75) or positive lymph nodes (median 23.33 vs 16.99, p=0.64). After controlling for confounders, administration of immunotherapy was not associated with better overall survival (HR 0.81, 95% CI 0.57 to 1.14).ConclusionsIn this study approximately one in four patients received adjuvant immunotherapy. Immunotherapy was not associated with improved overall survival.

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