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Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases
- Source :
- Gynecologic Oncology Reports, Vol 49, Iss , Pp 101268- (2023)
- Publication Year :
- 2023
- Publisher :
- Elsevier, 2023.
-
Abstract
- Objectives: To determine the influence of margin status, including preinvasive disease at the margin, on local recurrence and overall survival (OS) in patients with vulvovaginal melanoma. Methods: All patients with Stage 0-III vulvovaginal melanoma treated with primary surgical management between 1/2010–12/2019 were included. Margin status was categorized as negative, preinvasive disease (atypical junctional melanocytic hyperplasia and melanoma in situ), and invasive melanoma. Kaplan-Meier analyses were performed for local progression free survival (PFS) and OS. The impact of clinical and pathologic factors on local PFS and OS were assessed with Cox-regression analyses. Results: Fifty patients with a median follow-up of 48 months (range 3–119) were included. The median age was 63 years (range 20–83). Twenty percent (N = 10) had Stage 0 disease, 18% (N = 9) had Stage I, 46% (N = 23) had Stage II, and 16% (N = 8) had Stage III. Forty-four percent (N = 22) of patients had negative surgical margins, 46% (N = 23) had preinvasive disease at the margins, and 10% (N = 5) had invasive melanoma at the margins. The 5-year local PFS was 63% (95% CI: 42–78%) and OS was 60% (95% CI: 42–74%). Age, Breslow depth, stage, margin status, and re-resection did not significantly impact local PFS. In patients with preinvasive disease at the margin, all who recurred locally had Stage I-II disease. Conclusion: Preinvasive disease at the surgical margins may play an important role in local recurrence in patients with Stage I-II vulvovaginal melanoma. Patients with early (Stage 0) and advanced (Stage III) disease rarely recur locally and may not benefit from re-resection.
Details
- Language :
- English
- ISSN :
- 23525789
- Volume :
- 49
- Issue :
- 101268-
- Database :
- Directory of Open Access Journals
- Journal :
- Gynecologic Oncology Reports
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.5f07df8e4b45d681c3058ac11f776e
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.gore.2023.101268