In a nutshell
The authors assessed the accuracy of the system used to classify the stages of mucosal melanoma of the female reproductive system.
Some background
Mucosal melanomas of the vagina and vulva (the external part of female genital organs) are rare cancer, accounting for 1-3% of all melanomas in women. These melanomas occur in particular tissues (mucous membranes) of vagina and vulva. Due to rarity of these diseases, guidelines related to diagnosis and treatments of these cancers are not well established. Therefore, patients with these melanomas are generally treated according to the rules established for other skin (cutaneous) melanoma. It is therefore important to find out if there are differences between mucosal melanoma and cutaneous melanoma in terms of symptoms, diagnosis and factors affecting the outcomes.
Methods & findings
The authors aimed to analyze signs, symptoms and outcomes of patients treated for melanoma of vagina or vulva.
The authors examined the medical records of 85 patients who were diagnosed and treated for melanoma of vagina (63) or vulva (22). The average thickness of the tumor (how far the cancer reached into the skin) was 3.3 mm.
The most commonly reported symptoms included lumps (21.2% of patients), bleeding (18.9% of patients), itching (17.6% of patients), and pain (8.2% of patients). Information on the cancer stage was available for 71 patients. 6 patients had stage 0 disease (the cancer is only in the upper layers of the tissue), 53 patients had stage I or II disease (the cancer has not spread to other parts of the body) and 12 had stage III disease (the cancer had spread to the lymph nodes).
Early stage (stages 0-II) cancer was linked with a better chance of survival. After 5 years, all patients with stage III cancer had died from the cancer, compared to 36.4% of patients with stage 0-II melanoma. Other factors that predicted survival were tumor thickness, ulceration (tumor breaking through skin’s surface) and how quickly the cancer cells grew.
The bottom line
The authors concluded that use of the cutaneous melanoma staging system was appropriate for vulvar and vaginal melanomas.
Published By :
Annals of Surgical Oncology
Date :
Nov 11, 2014
