Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases
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/...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578923001376 |
| _version_ | 1797689312611926016 |
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| author | Alli M. Straubhar May P. Chan Shitanshu Uppal |
| author_facet | Alli M. Straubhar May P. Chan Shitanshu Uppal |
| author_sort | Alli M. Straubhar |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T01:43:53Z |
| format | Article |
| id | doaj.art-ed5f07df8e4b45d681c3058ac11f776e |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-03-12T01:43:53Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-ed5f07df8e4b45d681c3058ac11f776e2023-09-10T04:24:22ZengElsevierGynecologic Oncology Reports2352-57892023-10-0149101268Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 casesAlli M. Straubhar0May P. Chan1Shitanshu Uppal2Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA; Corresponding author at: University of Michigan, 1500 E Medical Drive, Ann Arbor, MI 48103, USA.Division of Dermatopathology, Department of Pathology, Michigan Medicine, NCRC Building 35, 2800 Plymouth Road, Ann Arbor, MI 48109, USADivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USAObjectives: 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.http://www.sciencedirect.com/science/article/pii/S2352578923001376Vulvovaginal melanomaSurgeryMargin status |
| spellingShingle | Alli M. Straubhar May P. Chan Shitanshu Uppal Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases Gynecologic Oncology Reports Vulvovaginal melanoma Surgery Margin status |
| title | Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases |
| title_full | Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases |
| title_fullStr | Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases |
| title_full_unstemmed | Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases |
| title_short | Margin status in vulvovaginal melanoma: Management and oncologic outcomes of 50 cases |
| title_sort | margin status in vulvovaginal melanoma management and oncologic outcomes of 50 cases |
| topic | Vulvovaginal melanoma Surgery Margin status |
| url | http://www.sciencedirect.com/science/article/pii/S2352578923001376 |
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