PRIMARY VAGINAL MELANOMA - IMPROVED SURVIVAL WITH RADICAL PELVIC-SURGERY

Primary vaginal melanoma is an aggressive and rare gynecological malig nancy with <150 reported cases to date. Historically, patients with th is disease have a poor prognosis for all types of treatment. In severa l studies containing small numbers of patients conservative therapy of ten has been recommended. Eight patients from our institute with this disease were divided into two groups according to therapy: Group A, ra dical (4); and Group B, conservative (4). The groups were compared for stage, age, surface area of the lesion, and quality of life. The 2-ye ar survival in Group A (75%) was significantly better than that of gro up B (0%). There was also found to be an improved 'survival in patient s who had lesions with a surface area <10 cm(2). Age and stage of dise ase did not affect prognosis. Quality of life was not reduced in the r adical group. A review of all reported cases since 1949 (119) was then performed. These were divided into the same Group A, radical (50); an d Group B, conservative (69). Again, a statistically significant impro ved outcome was found with the radically treated patients (48%) when c ompared to the conservatively treated patients (20%). Our findings sug gest that radical surgery for patients with primary vaginal melanoma i s recommended in patients with lesions <10 cm(2). (C) 1994 Academic Pr ess Inc.