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Vulvar Melanoma

2007; Lippincott Williams & Wilkins; Volume: 110; Issue: 2 Linguagem: Inglês

10.1097/01.aog.0000271209.67461.91

1873-233X

Valerie Sugiyama, John K. Chan, Jacob Y. Shin, Jonathan S. Berek, Kathryn Osann, Daniel S. Kapp,

Immunotherapy and Immune Responses

In Brief OBJECTIVES: To determine the prognostic factors associated with the survival of vulvar melanoma patients. METHODS: Data were obtained from the Surveillance Epidemiology and End Results database from 1973 to 2003. Kaplan-Meier survival curves and Cox regression models were used for analysis. RESULTS: Of the 644 vulvar melanoma patients, the median age was 68 years. Of these 572 women were white, 28 were Hispanic, 18 were African-American, and 14 were Asian. A total of 302 had localized disease, 168 had regional disease, and 28 had distant disease. Of the participants who underwent surgical resection, 171 (26.6%) had conservative surgery, 164 (25.5%) had radical excision, and 241 (37.5%) had unspecified surgical resections. One hundred seventy-nine (27.8%) had lymph node resections, and 33 patients had concurrent radiation therapy. Nodal metastases were identified in 58 (9%) of the participants. The 5-year disease-specific survival rates for those with localized, regional, and distant disease were 75.5%, 38.7%, and 22.1%, respectively (P<.001). Women aged 68 years or younger had a better survival rate than older patients (72.0% compared with 47.7%; P<.001). Those with 0, 1, and 2 or more positive lymph nodes had survival rates of 68.3%, 29%, and 19.5%, respectively (P<.001). In a multivariable analysis, younger age, localized disease, and negative lymph nodes were independent prognostic factors for improved survival. CONCLUSION: Age, stage, and lymph node involvement were significant factors for survival in vulvar melanoma. LEVEL OF EVIDENCE: III Age, stage, and lymph node involvement were significant factors for survival in women with vulvar melanoma.