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Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment

Ten percent of all women have pigmented vulvar lesions. Fortunately, most of these are benign but 1% of all melanomas in women affect the vulva. While the mortality rate of cutaneous melanoma has dropped by 7% annually during the last 5 years, the prognosis of vulvar melanoma remains dismal: the 5-y...

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Autores principales: Wohlmuth, Christoph, Wohlmuth-Wieser, Iris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421300/
https://www.ncbi.nlm.nih.gov/pubmed/34125416
http://dx.doi.org/10.1007/s40257-021-00614-7
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author Wohlmuth, Christoph
Wohlmuth-Wieser, Iris
author_facet Wohlmuth, Christoph
Wohlmuth-Wieser, Iris
author_sort Wohlmuth, Christoph
collection PubMed
description Ten percent of all women have pigmented vulvar lesions. Fortunately, most of these are benign but 1% of all melanomas in women affect the vulva. While the mortality rate of cutaneous melanoma has dropped by 7% annually during the last 5 years, the prognosis of vulvar melanoma remains dismal: the 5-year overall survival rate is 47% compared with 92% for cutaneous melanoma. The current evidence suggests that this likely results from a combination of delayed diagnosis and different tumor biology, treatment strategies, and treatment response. Although many landmark trials on checkpoint inhibitors included mucosal and vulvar melanomas, the results were often not reported separately. Post-hoc analyses indicate overall response rates between 19 and 37% for checkpoint inhibitors. A recently published retrospective study on vulvar melanomas suggests an objective response in 33.3% with a similar safety profile to cutaneous melanoma. Tyrosine kinase inhibitors may be considered in recurrent disease if a c-KIT mutation is present.
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spelling pubmed-84213002021-09-09 Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment Wohlmuth, Christoph Wohlmuth-Wieser, Iris Am J Clin Dermatol Review Article Ten percent of all women have pigmented vulvar lesions. Fortunately, most of these are benign but 1% of all melanomas in women affect the vulva. While the mortality rate of cutaneous melanoma has dropped by 7% annually during the last 5 years, the prognosis of vulvar melanoma remains dismal: the 5-year overall survival rate is 47% compared with 92% for cutaneous melanoma. The current evidence suggests that this likely results from a combination of delayed diagnosis and different tumor biology, treatment strategies, and treatment response. Although many landmark trials on checkpoint inhibitors included mucosal and vulvar melanomas, the results were often not reported separately. Post-hoc analyses indicate overall response rates between 19 and 37% for checkpoint inhibitors. A recently published retrospective study on vulvar melanomas suggests an objective response in 33.3% with a similar safety profile to cutaneous melanoma. Tyrosine kinase inhibitors may be considered in recurrent disease if a c-KIT mutation is present. Springer International Publishing 2021-06-14 2021 /pmc/articles/PMC8421300/ /pubmed/34125416 http://dx.doi.org/10.1007/s40257-021-00614-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Review Article
Wohlmuth, Christoph
Wohlmuth-Wieser, Iris
Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment
title Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment
title_full Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment
title_fullStr Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment
title_full_unstemmed Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment
title_short Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment
title_sort vulvar melanoma: molecular characteristics, diagnosis, surgical management, and medical treatment
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421300/
https://www.ncbi.nlm.nih.gov/pubmed/34125416
http://dx.doi.org/10.1007/s40257-021-00614-7
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