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Abstract
Introduction/Background Primary malignant melanoma of the vagina (PMMV) and cervix (PMMC) are exceedingly rare neoplasms associated with a dismal prognosis, for which there is a paucity of well-defined protocols or standardized treatment guidelines. The optimal management approach for early-stage PMMV and PMMC is surgical intervention; however, there is a paucity of comprehensive reports elucidating the impact of different surgical procedures on oncologic outcomes. This study aimed to compare the outcomes of open and minimally invasive surgery (MIS) in PMMV and PMMC. And our study simultaneously investigated the prognostic risk factors associated with PMMV and PMMC.
Methodology A retrospective cohort study was conducted of PMMV and PMMC patients with surgery treatment between January 2010 and July 2021. We retrospectively evaluated the clinicopathological features and surgical outcomes of these patients. All cases underwent either open or MIS surgery procedures. Disease-Free Survival (DFS) were compared between the groups.
Results Out of 45 eligible patients, 16 (35.6%) underwent MIS, while the remaining 29 (64.4%) opted for open surgery. The clinicopathological features and surgical outcomes of all patients are shown in table 1 and table 2. In the open surgery group, there was a significant higher rate of 2 years recurrence (42.2% versus 11.1%, P=0.027) compared to the MIS group. The incidence of positive surgical margins was significantly lower in the MIS group compared to the open surgery group (2.2% versus 24.4%, P=0.033). Multivariate logistic regression analysis showed that the independent factors influencing recurrence included type of hysterectomy, surgical marginand total vaginal resection (P < 0.05)(table 3,figure1). MIS has the potential to improve surgical outcomes (table 2, figure2).
Conclusion The total vaginal resection has the potential to improve DFS in patients with PMMV and PMMC. MIS provides better clinical benefits and is considered preferable. However, the impact of different surgical procedures on overall survival (OS) requires further investigation.
Disclosures No potential competing interest was reported by the author(s).
Clinopathological characteristics of patients
Surgical outcomes of patients
Multivariate cox regression analysis of DFS
