Skip Navigation LinksHome > August 2007 - Volume 110 - Issue 2, Part 1 > Vulvar Melanoma: A Multivariable Analysis of 644 Patients
Obstetrics & Gynecology:
doi: 10.1097/01.AOG.0000271209.67461.91
Original Research

Vulvar Melanoma: A Multivariable Analysis of 644 Patients

Sugiyama, Valerie E. MD2; Chan, John K. MD1; Shin, Jacob Y.2; Berek, Jonathan S. MD, MMS2; Osann, Kathryn PhD4; Kapp, Daniel S. MD, PhD3

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Abstract

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

© 2007 The American College of Obstetricians and Gynecologists

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