Malignant melanoma of the vulva: a clinicopathological study of 50 women

Article Abstract:

Malignant melanoma is a type of skin cancer composed of abnormal melanocytes (pigmented skin cells). Malignant melanoma of the vulva, the external area of the vagina, is uncommon. Malignant melanoma accounts for only 8 to 11 percent of all tumors of the vulva, but it is the second most common vulval cancer next to squamous cell carcinoma. In the West Midlands region of England malignant melanoma represents 3.6 percent of all vulval cancers. The prognosis of patients with malignant melanoma of the vulva is poor because the disease has a tendency to recur and to spread to other areas of the body. To see if there are any factors that can predict prognosis, 50 women with primary malignant melanoma of the vulva were studied. The overall five-year survival rate was 35 percent. The tumors were examined microscopically to determine the thickness of the tumor, type of growth pattern, ulceration (open wounds), shape, cell type, rate of cell division and amount of immune cells present in the tumor margins. Women older than 65 years of age who had thicker tumors had the poorest prognosis. The thickness of the tumor was a good prognostic indicator but did not function independently of tumor grade. Tumors that were less than one millimeter thick and Clark's level one or two (based on Clark's tumor staging system) had a good prognosis. Ulcerated tumors appeared to be more aggressive and therefore associated with a poor prognosis. The rate of cell division and the cell type were good prognostic indicators but less important than ulceration. The type of surgery performed did not seem to affect survival. The overall prognosis of malignant melanoma of the vulva is poor, primarily because the disease is generally is usually in its advanced stages at the time of diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Melanoma

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A pilot study of chemo-radiotherapy in advanced carcinoma of the vulva

Article Abstract:

Cancer of the vulva, the external region of the female genitals, represents 4 percent of all gynecological cancers. Surgical removal of the cancer in its early stages is associated with a 80 to 90 percent five-year survival rate, but survival rates are lower with advanced disease. Some surgeons have advocated shrinking the tumors with radiotherapy prior to surgical removal to maintain the integrity of the neighboring bowel and bladder. Combined chemotherapy and radiotherapy has been useful in treating cancer of the anus. To see if similar treatment regimens are useful in treating advanced cancer of the vulva (stages III and IV), 12 patients were studied, nine with primary cancer and three with recurrent cancer. The treatment schedules were designed individually. The chemotherapy portion of the combined therapy consisted of mitomycin-C and 5-fluorouracil. Seven patients completed the split course of chemotherapy and radiotherapy with a one-month rest period between courses. One patient died from treatment-related causes. The remaining patients, all of whom have died, experienced an average disease-free period of five months. The average survival was seven months. Of the patients receiving continuous combined therapy, one died prior to surgical tumor removal (cancer spread to the lungs) and three patients remained without disease for an average of six to nine months. One patient receiving treatment to reduce symptoms only (palliative treatment) died after six months. Two patients had surgery to remove the entire vulva (vulvectomy). One still has residual tumor, but remains alive at nine months; the another patient is in complete remission without having surgery. The continuous combined therapy was well-tolerated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Radiotherapy, Squamous cell carcinoma, Chemotherapy

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