Lower Genital Tract Melanomas: Staging, Predictors of Outcome, and New Therapeutic Options.
Aged
Aged, 80 and over
Antineoplastic Agents, Immunological
/ therapeutic use
Combined Modality Therapy
/ methods
Female
Gynecologic Surgical Procedures
Humans
Immunotherapy
Kaplan-Meier Estimate
Margins of Excision
Melanoma
/ mortality
Middle Aged
Neoplasm Staging
Oncolytic Viruses
/ physiology
Radiotherapy
Retrospective Studies
Treatment Outcome
Vaginal Neoplasms
/ mortality
Vulvar Neoplasms
/ mortality
Lower genital tract melanoma
immunotherapy
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
13
12
2020
revised:
28
12
2020
accepted:
29
12
2020
entrez:
31
1
2021
pubmed:
1
2
2021
medline:
7
2
2021
Statut:
ppublish
Résumé
Identification of predictors of survival of patients with lower genital tract melanoma (LGTM) and evaluation of the effectiveness of immunotherapy. Data of twenty women with LGTM were retrospectively collected. Survival outcomes were evaluated using the Kaplan-Meier method. Survival distributions were analyzed using the Log rank test. Twenty patients with LGTM (6 vaginal/14 vulvar) were evaluated. Factors significantly affecting Five-year OS was the stage of the American Joint Committee on Cancer (AJCC 2017) (I+II: 55.6% vs. III+IV: 25.9%; p=0.030) and the T-Stage (I+II: 100% vs. III+IV: 7.5%; p=0.280). Factors negatively affecting Five-year PFS was T-Stage >II (p=0.005), AJCC stage >II (p<0.001), depth of tumor infiltration >3 mm (p=0.008), nodal involvement (p=0.013), distant disease (p=0.002), and resection margins <10 mm (p=0.024). Nine patients received immunotherapy [median duration of response (DOR)=4 months]. Three patients received immuno- and radiation therapy (median DOR of 5 months). Two patients received T-VEC, only one responded. Surgery has a therapeutic effect in early stage LGTM. Advanced stages may be treated with immunotherapy, radiation therapy, a combination of both, and oncolytic viral immunotherapy.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Identification of predictors of survival of patients with lower genital tract melanoma (LGTM) and evaluation of the effectiveness of immunotherapy.
PATIENTS AND METHODS
METHODS
Data of twenty women with LGTM were retrospectively collected. Survival outcomes were evaluated using the Kaplan-Meier method. Survival distributions were analyzed using the Log rank test.
RESULTS
RESULTS
Twenty patients with LGTM (6 vaginal/14 vulvar) were evaluated. Factors significantly affecting Five-year OS was the stage of the American Joint Committee on Cancer (AJCC 2017) (I+II: 55.6% vs. III+IV: 25.9%; p=0.030) and the T-Stage (I+II: 100% vs. III+IV: 7.5%; p=0.280). Factors negatively affecting Five-year PFS was T-Stage >II (p=0.005), AJCC stage >II (p<0.001), depth of tumor infiltration >3 mm (p=0.008), nodal involvement (p=0.013), distant disease (p=0.002), and resection margins <10 mm (p=0.024). Nine patients received immunotherapy [median duration of response (DOR)=4 months]. Three patients received immuno- and radiation therapy (median DOR of 5 months). Two patients received T-VEC, only one responded.
CONCLUSION
CONCLUSIONS
Surgery has a therapeutic effect in early stage LGTM. Advanced stages may be treated with immunotherapy, radiation therapy, a combination of both, and oncolytic viral immunotherapy.
Identifiants
pubmed: 33517307
pii: 41/2/999
doi: 10.21873/anticanres.14854
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
999-1004Informations de copyright
Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.