Vulvar melanoma (VuM) and vaginal melanoma (VaM) are distinct subtypes of malignant melanomas with distinct biology and therapy. The study’s goal was to characterise the epidemiology and prognosis of VuM and VaM in a large representative cohort. The Surveillance, Epidemiology, and End Results-18 sample, which represents 27.8 percent of the US population, was used to identify women with invasive VuM or VaM. Age, ethnicity, stage, location, histology, initial surgery, and lymphadenectomy information were gathered. To examine disease-specific and overall survival, the Kaplan–Meier technique was employed. To find variables having a significant relationship with disease-specific survival, univariate and multivariate regression models were utilised. 78.6 percent and 49.7 percent of women with VuM and VaM underwent surgery, respectively, but only 52.9 percent of women with non-metastatic VuM and 42.9 percent of women with non-metastatic VaM undergoing surgery had lymph node assessment, with one-third having positive nodes. In VuM, the most prevalent subtype was superficial spreading, while in VaM, the most common subtype was nodular melanoma. In VuM, survival was substantially linked with age at diagnosis, ethnicity, stage, surgery, lymph node metastases, histologic subtype, ulceration, mitotic count, and tumour thickness, whereas in VaM, survival was strongly associated with stage, surgery, and lymph node involvement. In the Cox model, lymph node status and the number of mitoses were independent predictors of outcome in VuM; only lymph node status remained significant in VaM.
The outlook for VuM and VaM remains bleak. The American Joint Committee on Cancer staging method is appropriate for VuM and should be utilised; nevertheless, lymph node status and mitotic rate are the most important indicators of survival. The status of lymph nodes should be determined, and individuals with positive nodes may be candidates for adjuvant therapy.
Reference: https://link.springer.com/article/10.1007/s40257-019-00487-x
