Department of Obstetrics and Gynecology, Wayne State University and Karmanos Cancer Institute, Detroit, MI 48201, USA
Int J Gynecol Cancer. 2013 Jul;23(6):1118-25. doi: 10.1097/IGC.0b013e3182980ffb.
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.
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.
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.
These findings emphasize that cutaneous and vulvar/vaginal melanomas have different clinicopathologic features and survival patterns.
本研究旨在比较外阴/阴道黑色素瘤与皮肤黑色素瘤患者在人口统计学特征、临床病理特征和生存方面的差异，并特别关注种族差异。
数据来自 1973 年至 2008 年的监测、流行病学和最终结果数据库。采用 Kaplan-Meier 曲线和 Cox 多因素模型进行统计学分析。
本研究纳入了 762 例外阴/阴道黑色素瘤患者和 55485 例皮肤黑色素瘤患者。外阴/阴道组中有 28 例患者和皮肤组中有 334 例患者为黑人（分别为 3.6%和 0.6%）。外阴/阴道组的中位诊断年龄为 68 岁，皮肤组为 52 岁（P <0.0001）。外阴/阴道组中有 350 例（45.9%）患者和皮肤组中有 46499 例（83.8%）患者为局限性疾病（P <0.0001），而外阴/阴道组中有 64 例（8.4%）患者和皮肤组中有 1520 例（2.7%）患者为晚期疾病（P = 0.0081）。黑人患者的中位生存时间为外阴/阴道组 16 个月，皮肤黑色素瘤组 124 个月（P <0.0001）。非黑人患者的中位生存时间为外阴/阴道组 39 个月，皮肤黑色素瘤组 319 个月（P <0.0001）。在针对 1988 年至 2008 年患者进行的多因素分析中，年龄、分期和阳性淋巴结是外阴/阴道黑色素瘤生存的阴性独立预后因素；而年龄、种族、分期、放疗和淋巴结阳性是皮肤黑色素瘤的阴性预后因素。
这些发现强调了皮肤和外阴/阴道黑色素瘤具有不同的临床病理特征和生存模式。
