title: Management of melanomas of the female genital tract.
abstract: OBJECTIVE
  The significant increase in cutaneous melanomas over the past 30 years has led to studies resulting in advances in their diagnosis, staging, surgical treatment, and adjuvant therapies. Similar approaches have been investigated in patients with far rarer malignant melanomas of the female genital tract. This review will summarize the current state of knowledge on the incidence, causes, presenting symptoms, prognostic factors, therapeutic approaches, and outcomes, site-by-site, for primary melanomas of the vulva, vagina, urethra, ovary, and the uterine cervix.
  
  
  RESULTS
  Surgery remains the initial treatment of choice for localized melanomas of the female genital tract, with less radical, organ function preserving resections demonstrating similar control rates compared with more radical surgical approaches in vulva and possibly vaginal melanomas. Radiation therapy may play a role in the treatment of patients with close resection margins, regional nodal metastasis, or unresectable tumors. Sentinel lymph node studies, positron emission tomography and computed tomography scans for staging and evaluation of response, and adjuvant chemo or biochemotherapy warrant further investigation.
  
  
  CONCLUSIONS
  The results of treatment for female genital tract melanomas remain poor. Although surgery remains the initial treatment of choice for localized disease, adjuvant local-regional, and systemic therapies are needed.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, Stanford, CA 94305-5847, USA.
authors.forename: Valerie E
authors.initials: VE
authors.lastname: Sugiyama
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kapp
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*