Lymph node status predicts survival in patients with vulvar, vaginal melanoma

Lymph node status is a predictor of survival in patients with vulvar melanoma and vaginal melanoma, according to a study published in American Journal of Clinical Dermatology.

“Based on ... recent advances in skin melanoma and the poor overall prognosis of genital melanomas reported in smaller series, comprehensive study of VuM and VaM is warranted,” the study authors wrote. “The aim of this study is to describe the epidemiologic, clinical and histopathologic characteristics of VuM and VaM and to analyze their impact on survival.”

In a population-based study of women with invasive vulvar melanoma (VuM) or vaginal melanoma (VaM), a total of 1,863 cases were identified to analyze factors associated with disease-specific survival and overall survival.

Of 1,400 patients with VuM, 78.6% underwent surgery; 52.9% of non-metastatic patients undergoing surgery also underwent lymph node assessment. The median overall survival rate was 53 months, and the median disease-specific survival rate was 99 months. Survival was significantly associated with age at diagnosis, ethnicity, stage, surgery, lymph node metastases, histologic subtype, ulceration, mitotic count and tumor thickness. A total of 664 patients with VuM died from melanoma.

Of 463 patients with VaM, 49.7% underwent surgery; 42.9% of non-metastatic patients undergoing surgery also underwent lymph node assessment. The median overall survival rate was 16 months, and the median disease-specific survival rate was 19 months. Survival was associated with stage, surgery and lymph node involvement. A total of 320 patients with VaM died from melanoma.

“Lymph node status and mitotic rate are the most important predictors for disease-specific survival,” the authors said. “Lymph node status should be assessed in all applicable patients with VuM and VaM. Those with positive lymph nodes may be candidates for adjuvant treatment.” – by Kate Burba

Disclosures: The authors report no relevant financial disclosures.