Vulvar malignant melanoma: Pathogenesis, clinical behaviour and management: Review of the literature.

Autor: Boer FL; Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands., Ten Eikelder MLG; Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands., Kapiteijn EH; Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands., Creutzberg CL; Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands., Galaal K; Department of Gynaecology, Royal Cornwall Hospital NHS Trust, United Kingdom., van Poelgeest MIE; Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: M.I.E.van_poelgeest@lumc.nl.
Jazyk: angličtina
Zdroj: Cancer treatment reviews [Cancer Treat Rev] 2019 Feb; Vol. 73, pp. 91-103. Date of Electronic Publication: 2018 Dec 24.
DOI: 10.1016/j.ctrv.2018.12.005
Abstrakt: Vulvar malignant melanoma (VMM) is a rare disease, accounting for 5% of all vulvar malignancies and is characterized by low survival and high recurrence rates. It is considered as a distinct entity of mucosal melanoma. Prognostic factors are higher age, advanced Breslow thickness, and lymph node involvement whilst central localization and ulceration status are still under debate. Surgery is the cornerstone for the treatment of primary VMM, however, it can be mutilating due to the anatomical location of the disease. Elective lymph node dissection is not part of standard care. The value of sentinel lymph node biopsy in VMM is still being studied. Radiation therapy and chemotherapy as adjuvant treatment do not benefit survival. Immunotherapy in cutaneous melanoma has shown promising results but clinical studies in VMM are scarce. In metastatic VMM, checkpoint inhibitors and in case of BRAF or KIT mutated metastatic VMM targeted therapy have shown clinical efficacy. In this review, we present an overview of clinical aspects, clinicopathological characteristics and its prognostic value and the latest view on (adjuvant) therapy and follow-up.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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