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A large retrospective multicenter study of vaginal melanomas: implications for new management.
MedLine Citation:
PMID:  23449321     Owner:  NLM     Status:  Publisher    
The outcome of patients presenting with vaginal melanoma has been assessed in a large multicentric retrospective study. The databases of 12 French institutions were searched for primary vaginal melanomas managed between 1990 and 2007. Among the 54 patients recorded, 46 were managed with a curative intent and included in the study. The clinical characteristics, treatments, and detection of c-KIT protein expression have been studied. The median age of the patients was 63.5 years (42-88). Twenty-eight patients were classified as International Federation of Gynecology and Obstetrics (FIGO) stage I, five as stage II, six as stage III, and one as stage IVA. c-KIT protein was overexpressed in 80% of the patients. Forty-two patients underwent surgical resection of the tumor, nine patients received local adjuvant treatment, and 10 received systemic adjuvant therapy. The median relapse-free survival was 10.9 months. c-KIT-negative status (P=0.01) and stage I (P=0.02) were associated with locoregional recurrence. The rate of metastasis was increased for advanced FIGO stages (P<0.01). The median overall survival (OS) was 28.4 months. The finding of lymph node metastasis adversely affected OS (P<0.01). Conservative surgery and radiotherapy were associated with a decrease in metastasis-free and OS (P<0.01) compared with surgery alone, this group of patients presenting with advanced FIGO stages (P=0.02). Despite the use of limited data, conservative surgery combined with a sentinel lymph node procedure, followed by adjuvant radiotherapy could be proposed to patients with early FIGO stage in the absence of validated management. c-KIT negativity by immunochemistry appears to be a poor prognosis marker in terms of locoregional recurrences but not for metastatic spread nor survival. Further assessment of the role of c-KIT expression in this disease is thus mandatory to select patients for targeted therapy.
Charlotte Vaysse; Patricia Pautier; Thomas Filleron; Veronique Maisongrosse; Jean-François Rodier; Vincent Lavoue; Fabien Reyal; Laurence Thomas; Arnaud de la Fouchardière; Martine Delannes
Publication Detail:
Journal Detail:
Title:  Melanoma research     Volume:  23     ISSN:  1473-5636     ISO Abbreviation:  Melanoma Res.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-3-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9109623     Medline TA:  Melanoma Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  138-146     Citation Subset:  -    
aDepartment of Surgery, Biostatistics, Biopathology and Radiotherapy, Institut Claudius Regaud, Toulouse bDepartment of Oncology, Institut Gustave Roussy, Villejuif cDepartment of Surgery, Institut Paul Strauss, Strasbourg dDepartment of Surgery, Hospital Anne de Bretagne, Rennes eDepartment of Surgery, Institut Curie, Paris fDepartment of Radiotherapy, Institut Bergonie, Bordeaux gDepartment of Biopathology, Institut Leon Berard, Lyon, France.
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