Management of vulvar melanoma Journal Article
| Authors: | Trimble, E. L.; Lewis, J. L. Jr; Williams, L. L.; Curtin, J. P.; Chapman, D.; Woodruff, J. M.; Rubin, S. C.; Hoskins, W. J. |
| Article Title: | Management of vulvar melanoma |
| Abstract: | Considerable debate centers on the optimal treatment for vulvar melanoma, as well as those clinicopathological factors influencing prognosis. We reviewed 80 patients with vulvar melanoma seen between 1949 and 1990. Primary tumors were assessed according to Chung (47 patients) and Breslow (65 patients) microstaging systems. Fifty-nine patients (76%) underwent radical vulvectomy, ten patients (13%) had a partial vulvectomy, and nine patients (12%) had a wide local excision. Fifty-six also underwent inguinal node dissection. Median follow-up was 193 months. Median survival was 63 months. Ten-year survival by Chung level was as follows: I 100%; II, 81%; III, 87%; IV, 11%; V, 33%. Ten-year survival by tumor thickness was as follows: 0.75 mm, 48%; 0.75-1.5 mm, 68%; 1.51-3.0 mm, 44%; >3.0 mm, 22%. Increased depth of invasion was associated with increased incidence of inguinal node metastasis. Cox regression analysis demonstrated prognostic significance for tumor thickness (P < 0.001), inguinal node metastasis (P < 0.001), and older age at diagnosis (P < 0.001). Radical vulvectomy did not seem to improve survival over less radical procedures. Based on this experience, we recommend radical local excision for patients with malignant melanoma of the vulva. Patients who have more than a superficially invasive melanoma should also have inguinal lymph node dissection. © 1992. |
| Keywords: | adolescent; adult; cancer survival; aged; aged, 80 and over; survival analysis; cancer surgery; excision; major clinical study; clinical feature; cancer staging; follow-up studies; lymph node metastasis; lymph node dissection; lymph nodes; lymphatic metastasis; melanoma; tumor volume; age; inguinal lymph node; regression analysis; vulvar neoplasms; middle age; vulva cancer; vulvectomy; prognosis; human; female; priority journal; article |
| Journal Title: | Gynecologic Oncology |
| Volume: | 45 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1992-06-01 |
| Start Page: | 254 |
| End Page: | 258 |
| Language: | English |
| DOI: | 10.1016/0090-8258(92)90300-8 |
| PUBMED: | 1612500 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 30 July 2019 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work