Iacoponi Sara, Rubio Patricia, Garcia Enrique, Oehler Martin K, Diez Javier, Diaz-De la Noval Begoña, Mora Pablo, Gardella Barbara, Gomez Ivan, Kotsopoulos Ioannis C, Zalewski Kamil, Zapardiel Ignacio
*Gynecologic Oncology Unit, La Paz University Hospital-IdiPAZ, Madrid; †Gynecology Department, Hospital Universitario Miguel Servet, Zaragoza; ‡Instituto Valenciano de Oncología, Valencia, Spain; §Department of Gynaecological Oncology, Royal Adelaide Hospital, Adelaide, Australia; ‖Hospital de Cruces, Vizcaya; ¶Gynecology Department, Hospital Universitario Central de Asturias, Asturias, Spain; #Hospital Clinico Universitario de Valladolid, Spain; **Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; ††Hospital Virgen del Camino, Pamplona, Spain; and ‡‡Gynecologic Oncology Department, Theagenio Cancer Hospital, Thessaloniki, Greece; §§Institute of Oncology, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland.
Int J Gynecol Cancer. 2016 Sep;26(7):1307-12. doi: 10.1097/IGC.0000000000000768.
The aim of this study was to analyze the prognostic factors related to the recurrence rate and overall survival of vulval melanoma patients by means of a subgroup analysis of the VULvar CANcer study.
The international multicenter VULvar CANcer study involved 100 international centers, which contributed 2453 vulvar cancer cases. Of the 1727 patients finally included in the study, 42 were suffering from vulvar melanoma (2.4%).
The mean follow-up for vulval melanoma patients was 44.1±35.7 months. Recurrence rate was 50%, and the mean recurrence-free survival was 43.5±6.6 months. For local recurrences, the mean recurrence-free interval was 63.3±8.6 months; for metastasis, 33.5±3.5 months. The 5-year recurrence-free survival rate was 28.6%. The mean overall survival for vulvar melanomas was 45.9±4 months and the 5-year overall survival rate was 78.6%. The only factor with prognostic significance regarding local recurrence of vulvar melanoma was tumor size (P = 0.003). American Joint Committee on Cancer staging was the only prognostic factor associated with metastatic disease at recurrence (P < 0.001). Finally, age of patient was significantly associated with overall survival (P < 0.001).
Tumor size and American Joint Committee on Cancer stage were independent prognostic factors associated with local and distant recurrence, respectively. Patients' age was the only independent prognostic factor associated with overall survival.
本研究旨在通过外阴癌研究的亚组分析，分析与外阴黑色素瘤患者复发率和总生存率相关的预后因素。
国际多中心外阴癌研究涉及100个国际中心，共提供了2453例外阴癌病例。最终纳入研究的1727例患者中，42例患有外阴黑色素瘤（2.4%）。
外阴黑色素瘤患者的平均随访时间为44.1±35.7个月。复发率为50%，平均无复发生存期为43.5±6.6个月。对于局部复发，平均无复发间隔为63.3±8.6个月；对于转移，为33.5±3.5个月。5年无复发生存率为28.6%。外阴黑色素瘤的平均总生存期为45.9±4个月，5年总生存率为78.6%。关于外阴黑色素瘤局部复发具有预后意义的唯一因素是肿瘤大小（P = 0.003）。美国癌症联合委员会分期是与复发时转移性疾病相关的唯一预后因素（P < 0.）。最后，患者年龄与总生存期显著相关（P < 0.001）。
肿瘤大小和美国癌症联合委员会分期分别是与局部和远处复发相关的独立预后因素。患者年龄是与总生存期相关的唯一独立预后因素。
