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Vulvar/Vaginal Melanoma: An Updated Surveillance Epidemiology and End Results Database Review, Comparison With Cutaneous Melanoma and Significance of Racial Disparities
  1. Ismail Mert, MD*,
  2. Assaad Semaan, MD*,
  3. Ira Winer, MD, PhD*,
  4. Robert T. Morris, MD* and
  5. Rouba Ali-Fehmi, MD
  1. *Departments of Obstetrics and Gynecology and
  2. Departments of Pathology, Wayne State University, Detroit, MI.
  1. Address correspondence and reprint requests to Rouba Ali-Fehmi, MD, Department of Pathology and Obstetrics and Gynecology, Wayne State University and Karmanos Cancer Institute, 3990 John R, Detroit, MI. 48201. E-mail: rali@med.wayne.edu.

Abstract

Objective We aimed to compare the differences in demographic features, clinicopathologic features, and survival in patients with vulvar/vaginal melanoma versus cutaneous melanoma with a special emphasis on race.

Materials and Methods Data were obtained from the Surveillance Epidemiology and End Results database from 1973 to 2008. Kaplan-Meier curves and Cox multivariate model were used for statistical analysis.

Results Seven hundred sixty-two patients with vulvar/vaginal melanoma and 55,485 patients with cutaneous melanoma patients were included in the study. Twenty-eight patients of the vulvar/vaginal group and 334 patients of the cutaneous group were black (3.6% vs 0.6%, respectively). The median age at the time of diagnosis was 68 years in the vulvar/vaginal group and 52 years in the cutaneous group (P < 0.0001). Three hundred fifty patients (45.9%) in the vulvar/vaginal and 46,499 patients (83.8%) in the cutaneous group presented with localized disease (P < 0.0001), whereas 64 patients (8.4%) in the vulvar/vaginal group and 1520 patients (2.7%) in cutaneous group presented with advanced disease (P = 0.0081). The median survival of the black patients was 16 months in the vulvar/vaginal group and 124 months in the cutaneous melanoma group (P < 0.0001). The median survival in the nonblack population was 39 months in the vulvar/vaginal group compared to 319 months in the cutaneous melanoma group (P <0.0001). In multivariate analysis performed for patients between 1988 and 2008, age, stage, and positive lymph nodes were negative independent prognostic factors for survival in vulvar/vaginal melanoma; whereas age, race, stage, radiation therapy, and lymph node positivity were negative prognostic factors in cutaneous melanoma.

Conclusion These findings emphasize that cutaneous and vulvar/vaginal melanomas have different clinicopathologic features and survival patterns.

  • Vulvar/Vaginal melanoma
  • Cutaneous melanoma
  • SEER
  • Racial disparity

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Footnotes

  • The preliminary data were presented at 41st AAGL Global Congress on Minimally invasive Gynecology, November 5–9, 2012, Las Vegas, USA.

  • The authors declare no conflicts of interest.