title: Clinicopathologic study of 85 cases of melanoma of the female genitalia.
abstract: BACKGROUND
  Melanoma of the female genitalia has poor overall prognosis.
  
  
  OBJECTIVE
  To examine prognostic factors influencing survival, the Duke Melanoma and Tumor Registry Databases were queried for patients who had received their clinical care at Duke University Medical Center, with a diagnosis of melanoma of the female genitalia, including vulva, vagina, and cervix, between 1970 and 2009. From this group, any available histopathologic specimens were procured for further review.
  
  
  RESULTS
  Eighty-five patients were identified. The median follow-up time was 8.8 years with 60% of the patients experiencing melanoma-related mortality at last follow-up. Survival rates at 1, 5, and 10 years were 85%, 51%, and 30%, respectively. The available histopathologic specimens from 36 cases were reviewed by a dermatopathologist (M.A.S.). Fifteen of 36 cases were notable for the presence of atypical melanocytic hyperplasia adjacent to the primary melanoma. Breslow depth, lymph node status, systemic therapy, and surgery were also examined for differences in survival distributions using the log-rank test. In general, survival was inversely correlated with Breslow depth, extent of nodal involvement, and provision of systemic therapy. A higher survival rate was observed among those who received wide local excision. Log-rank test demonstrated that survival between different decades of diagnosis was not significantly different.
  
  
  CONCLUSIONS
  Because of its small sample size, this study may be underpowered.
  
  
  CONCLUSIONS
  Despite new treatments developed and attempted, there is no evidence that survival has improved over the past 40 years. In summary, patients with thinner melanomas amenable to surgical resection had a better prognosis than those with more extensive, metastatic disease at presentation.
authors.affiliation: Department of Dermatology, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Win J
authors.initials: WJ
authors.lastname: Tcheung
authors.forename: Maria A
authors.initials: MA
authors.lastname: Selim
authors.forename: James E
authors.initials: JE
authors.lastname: Herndon
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008545:Melanoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy / Q000401:mortality; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D014625:Vaginal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D014846:Vulvar Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D055815:Young Adult