Abstract:

Background and purpose: Primary malignant melanomas of the uterine cervix and vagina are rare neoplasms with very poor prognosis. This article aimed at investigating the clinicopathologic characteristics, treatment and prognosis of primary malignant melanomas of the cervix and vagina. Methods: The clinical data of 51 patients with primary malignant melanomas of the cervix and vagina treated at Fudan University Shanghai Cancer Center from Dec.1998 to Jul. 2011 were reviewed. Results: The 2- and 4-year progression-free survival (PFS) rates were 32.8% and 13.1%, respectively. The 2- and 4-year overall survival (OS) rates were 67.2% and 39.8%, respectively. Three patients survived more than 5 years. Twenty-nine (56.9%) patients had a recurrence. The common sites were vaginal stump/pelvis (10 patients, 34.5%), liver (4 patients, 13.9%), lung (3 patients, 10.3%), bone (3 patients, 10.3%) and vulva (3 patients, 10.3%). Larger tumor size and lymphovascular space invasion were the independent predictors of poor OS (P<0.05). Pelvic lymph nodes metastases were associated with shorter PFS (P=0.05). Among them, those who received combined immunotherapy and chemoradiotherapy achieved longer median time to progression (TTP) (17 months) compared with patients who had chemotherapy alone (9 months) or immunotherapy alone (11 months). Conclusion: Primary melanomas of cervix and vagina have a very poor prognosis. The multidisciplinary treatment of combining surgery, chemoradiotherapy, and immunotherapy can improve the patients’ prognosis.

Key words: Vaginal melanoma, Cervical melanoma, Surgery, Chemotherapy, Radiotherapy, Immunotherapy, Prognosis