A survey of hospital management practices for vulvar melanoma

Background: Vulvar melanoma is a very rare form of cancer. The purpose of t his study was to describe practice patterns for the management of vulvar me lanoma. Study Design: The National Cancer Data Base was reviewed from 1985 through 1994 for patient reports submitted with, a diagnosis of vulvar melanoma. Results: Five hundred sixty-nine patients with vulvar melanoma were identif ied. A substantial number of patients were older; during the latter period of this study (1990 to 1994), 50% were 70 years old or older. Surgery was u sed in more than 90% of patients with stages 0 to III. Local excision was u sed mainly in early-stage (0 and I) disease. Adjuvant therapy was used infr equently. Lymph node evaluation was performed in more than half of the pati ents, with greater frequency for patients who had advanced disease. The ove rall 5-year relative survival rate was 62%. If the lymph nodes contained me tastases, survival was poor Patients with recurrent disease also had poor s urvival. Conclusions: Surgery remains the mainstay of therapy for vulvar melanoma. T he use of excision and radical operations remained constant during the 10 y ears of the study. (J Am Cell Surg 1999;188:670-675. (C) 1999 by the Americ an College of Surgeons).