Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2022, Vol. 18 ›› Issue (06): 621 -626. doi: 10.3877/cma.j.issn.1673-5250.2022.06.001

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Research progress on diagnosis and therapy for vaginal melanoma

Xiaofang Zhang, Ping Wang()   

  1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2022-03-11 Revised:2022-08-15 Published:2022-12-01
  • Corresponding author: Ping Wang
  • Supported by:
    Key Research and Development Project of Science and Technology Department in Sichuan Province(2021YFS0015)

Vaginal melanoma (VM) is a rare malignant tumor with poor prognosis, accounting for around 3% of all vaginal malignancies, and usually occur in older women. VM has a poorer 5-year overall survival (OS) rate than cutaneous, ocular, and vulvar melanoma, with 5-year OS rate of 13%-32.3%. Consensus on staging system or treatment regimen for patients with VM has yet to be established. Surgical excision is the preferred treatment for patients with early-stage VM, and postoperative adjuvant therapy such as radiotherapy, chemotherapy and cytokine therapy may improve their OS rate. Immunotherapy and targeted therapy may be promising approaches for treating patients with advanced VM. However, their curative effects still need further evaluation with solid evidence by large samples, prospective randomized controlled trials of patients with VM. This article reviews the latest research progresses of pathogenesis of VM, clinical manifestations and clinical stage of patients with VM, treatment and prognosis of patients with VM, especially for immunotherapy and targeted therapy.

[1]
Wang D, Xu T, Zhu H, et al. Primary malignant melanomas of the female lower genital tract: clinicopathological characteristics and management[J]. Am J Cancer Res, 2020, 10(12): 4017-4037.
[2]
Gadducci A, Carinelli S, Guerrieri ME, et al. Melanoma of the lower genital tract: prognostic factors and treatment modalities[J]. Gynecol Oncol, 2018, 150(1): 180-189. DOI: 10.1016/j.ygyno.2018.04.562.
[3]
Joste M, Dion L, Brousse S, et al. Vulvar and vaginal melanomas: a retrospective study spanning 19 years from a tertiary center[J]. J Gynecol Obstet Hum Reprod, 2021, 50(5): 102091. DOI: 10.1016/j.jogoh.2021.102091.
[4]
Ottaviano M, Giunta EF, Marandino L, et al. Anorectal and genital mucosal melanoma: diagnostic challenges, current knowledge and therapeutic opportunities of rare melanomas[J]. Biomedicines, 2022, 10(1): 150. DOI: 10.3390/biomedicines10010150.
[5]
Cancer Genome Atlas Network. Genomic classification of cutaneous melanoma[J]. Cell, 2015, 161(7): 1681-1696. DOI: 10.1016/j.cell.2015.05.044.
[6]
Beaudoux O, Oudart JB, Riffaud L, et al. Mutational characteristics of primary mucosal melanoma: a systematic review[J]. Mol Diagn Ther, 2022, 26(2): 189-202. DOI: 10.1007/s40291-021-00572-0.
[7]
中华医学会病理学分会,中华医学会病理学分会皮肤病理学组. 黑色素瘤病理诊断临床实践指南(2021版)[J]. 中华病理学杂志2021, 50(6): 572-582. DOI: 10.3760/cma.j.cn112151-20210417-00299.
[8]
Dobric EC, Vâjâitu C, Condrat CE, et al. Vulvar and vaginal melanomas-the darker shades of gynecological cancers[J]. Biomedicines, 2021, 9(7): 758. DOI: 10.3390/biomedicines9070758.
[9]
Shakeel O, Ullah F, Khalid N, et al. Malignant melanoma of the female genital tract: experience of an oncology center in Pakistan[J]. Cureus, 2020, 12(6):e8484. DOI: 10.7759/cureus.8484.
[10]
李慧青,王东,莫佳娅,等. 原发性阴道恶性黑色素瘤患者预后影响因素分析:32例病例报道及系统评价[J]. 肿瘤基础与临床2021, 34(1): 41-47. DOI: 10.3969/j.issn.1673-5412.2021.01.009.
[11]
张师前,林仲秋,张颖. 外阴、阴道黑色素瘤诊断与治疗的专家推荐意见(2021年版)[J]. 中国实用妇科与产科杂志2021, 37(7): 731-739. DOI: 10.19538/j.fk2021070111.
[12]
中国抗癌协会妇科肿瘤专业委员会. 阴道恶性肿瘤诊断与治疗指南(2021年版)[J]. 中国癌症杂志2021, 31(6): 546-560. DOI: 10.19401/j.cnki.1007-3639.2021.06.12.
[13]
Amin MB, Edge SB, Greene FL, et al. AJCC cancer staging manual[M]. 8th ed. New York: Springer, 2017: 1-1024.
[14]
Adams TS, Rogers LJ, Cuello MA. Cancer of the vagina: 2021 update[J]. Int J Gynaecol Obstet, 2021, 155(Suppl 1): 19-27. DOI: 10.1002/ijgo.13867.
[15]
Platt S, Wilson E, Pawade J, et al. Review of gynaecological malignant melanomas[J]. Obstet Gynaecol, 2020, 22(3): 199-207. DOI: 10.1111/tog.12666.
[16]
Wohlmuth C, Wohlmuth-Wieser I, May T, et al. Malignant melanoma of the vulva and vagina: a US population-based study of 1 863 patients[J]. Am J Clin Dermatol, 2020, 21(2): 285-295. DOI: 10.1007/s40257-019-00487-x.
[17]
Lewin J, Egbe A, Ellery P, et al. Female genital tract melanoma: 10 years of experience at a single tertiary center[J]. J Low Genit Tract Dis, 2021, 25(2): 142-145. DOI: 10.1097/lgt.0000000000000591.
[18]
Tian H, Wang X, Lian B, et al. Surgical outcomes of vaginal or cervical melanoma[J]. Front Surg, 2021, 8: 771160. DOI: 10.3389/fsurg.2021.771160.
[19]
Sinasac SE, Petrella TM, Rouzbahman M, et al. Melanoma of the vulva and vagina: surgical management and outcomes based on a clinicopathologic review of 68 cases[J]. J Obstet Gynaecol Can, 2019, 41(6): 762-771. DOI: 10.1016/j.jogc.2018.07.011.
[20]
Tian H, Wang X, Lian B, et al. Surgical outcomes of vaginal or cervical melanoma[J]. Front Surg, 2022, 8: 771160. DOI: 10.3389/fsurg.2021.771160.
[21]
Lopez S, Guerrisi R, Brusadelli C, et al. The role of sentinel lymph node mapping in lower genital tract melanoma[J]. Minerva Ginecol, 2020, 72(6): 384-390. DOI: 10.23736/s0026-4784.20.04628-6.
[22]
Yazdanfard NW, Mikkelsen LH, Behrendt N, et al. Vaginal melanoma in Denmark from 1980 to 2018: a population-based study based on genetic profile and survival[J]. Gynecol Oncol, 2022, 165(1): 53-59. DOI: 10.1016/j.ygyno.2022.01.028.
[23]
Murata H, Okonogi N, Wakatsuki M, et al. Long-term outcomes of carbon-ion radiotherapy for malignant gynecological melanoma[J]. Cancers (Basel), 2019, 11(4): 482. DOI: 10.3390/cancers11040482.
[24]
Komatsu-Fujii T, Nomura M, Otsuka A, et al. Response to imatinib in vaginal melanoma with KIT p.Val559Gly mutation previously treated with nivolumab, pembrolizumab and ipilimumab[J]. J Dermatol, 2019, 46(6): e203-e204. DOI: 10.1111/1346-8138.14763.
[25]
Lian B, Cui C, Song X, et al. Phase Ⅲ randomized, multicenter trial comparing high-dose IFN-a2b with temozolomide plus cisplatin as adjuvant therapy for resected mucosal melanoma[J]. J Clin Oncol, 2018, 36(15_suppl): 9589. DOI: 10.1200/JCO.2018.36.15_suppl.9589.
[26]
Yan X, Sheng X, Chi Z, et al. Randomized phase Ⅱ study of bevacizumab in combination with carboplatin plus paclitaxel in patients with previously untreated advanced mucosal melanoma[J]. J Clin Oncol, 2021, 39(8): 881-889. DOI: 10.1200/jco.20.00902.
[27]
Dimitriou F, Long GV, Menzies AM. Novel adjuvant options for cutaneous melanoma[J]. Ann Oncol, 2021, 32(7): 854-865. DOI: 10.1016/j.annonc.2021.03.198.
[28]
Swetter SM, Thompson JA, Albertini MR. NCCN Clinical Practice Guidelines in Oncology. Melanoma: cutaneous (version 2.2022)[EB/OL]. (2022-01-27)[2022-07-16].

URL    
[29]
Wilhite A, Wu S, Xiu J, et al. Too much skin in the game? A paradigm shift in our understanding of vulvar and vaginal melanomas as distinct tumor types compared with cutaneous melanomas[J]. Gynecol Oncol, 2021, 162(suppl 1): S33-S34. DOI: 10.1016/s0090-8258(21)00708-3.
[30]
Wilhite A, Wu S, Zeng J, et al. P28 investigating molecular profiles of subtypes of mucosal melanomas: is vulvovaginal melanoma a distinct entity?[J]. Gynecol Oncol, 2022, 165(suppl 1): S20-S21. DOI: 10.1016/s0090-8258(22)00373-0.
[31]
Quéreux G, Wylomanski S, Bouquin R, et al. Are checkpoint inhibitors a valuable option for metastatic or unresectable vulvar and vaginal melanomas?[J]. J Eur Acad Dermatol Venereol, 2018, 32(1): e39-e40. DOI: 10.1111/jdv.14486.
[32]
Yu Y, Tse KY, Lee HHY, et al. Predictive biomarkers and tumor microenvironment in female genital melanomas: a multi-institutional study of 55 cases[J]. Mod Pathol, 2020, 33(1): 138-152. DOI: 10.1038/s41379-019-0345-2.
[33]
Indini A, Di Guardo L, Cimminiello C, et al. Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience[J]. J Gynecol Oncol, 2019, 30(6): e94. DOI: 10.3802/jgo.2019.30.e94.
[34]
Herrera FG, Ronet C, Ochoa de Olza M, et al. Low-dose radiotherapy reverses tumor immune desertification and resistance to immunotherapy[J]. Cancer Discov, 2022, 12(1): 108-133. DOI: 10.1158/2159-8290.CD-21-0003.
[35]
Shi K, Zhang B, Kong BY, et al. Distinct genomic features in a retrospective cohort of mucosal, acral and vulvovaginal melanomas[J]. J Am Acad Dermatol, 2019: S0190-9622(19)32374-6. DOI: 10.1016/j.jaad.2019.07.017.
[36]
Zarei S, Voss JS, Jin L, et al. Mutational profile in vulvar, vaginal, and urethral melanomas: review of 37 cases with focus on primary tumor site[J]. Int J Gynecol Pathol, 2020, 39(6): 587-594. DOI: 10.1097/pgp.0000000000000636.
[37]
Wang HY, Wu XY, Zhang X, et al. Prevalence of NRAS mutation, PD-L1 expression and amplification, and overall survival analysis in 36 primary vaginal melanomas[J]. Oncologist, 2020, 25(2): e291-e301. DOI: 10.1634/theoncologist.2019-0148.
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