Prognostic indicators in melanoma of the vulva.
BACKGROUND
The aim of this study was to evaluate the prognostic significance of clinical-pathologic variables in melanoma of the vulva.


METHODS
From 1979 through 1995, 40 women with a diagnosis of vulvar melanoma underwent radical surgery. Patient age, tumor size and site, histologic type, ulceration, tumor thickness, lymph node status, and number of positive lymph nodes were assessed for prognostic significance by multivariate analysis.


RESULTS
Tumor thickness was a significant predictor of lymph node involvement, but not of survival. The most powerful predictors of survival by multivariate analysis were the lymph node status (P = .002) and the number of positive lymph nodes (P = .00003).


CONCLUSIONS
The number of positive lymph nodes represents the strongest prognostic factor in melanoma of the vulva. Because of the lack of effective adjuvant therapies, such prognostic indicators might be used to define the timing and extent of the surgical approach.
Raspagliesi
F
F
Department of Gynecologic Oncology, Istituto Nazionale Tumori, Milan, Italy. dittotony@hotmail.com
Ditto
A
A
Paladini
D
D
Fontanelli
R
R
Stefanon
B
B
Dipalma
S
S
De Palo
G
G
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014846:Vulvar Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery