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Debate 51B - Is Pelvic Exenteration an Option for a Pelvic Recurrence of a Vulvar/Vaginal Melanoma after Previous Radiation Therapy?

No

from Section VI - Vaginal and Vulvar Cancer

Published online by Cambridge University Press:  20 July 2023

By
Mario M. Leitao
Edited by
Dennis S. Chi ,
Nisha Lakhi  and
Nicoletta Colombo
Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

Patients with vulvovaginal melanoma should not be considered for pelvic exenteration except possibly as a last resort in very rare, highly select cases. Instead, these patients may be best treated with a combination of hypofractionated radiation therapy and immunotherapy.

Type
Chapter
Information
50 Big Debates in Gynecologic Oncology , pp. 310 - 312
Publisher: Cambridge University Press
Print publication year: 2023

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References

Mert, I, et al. Vulvar/vaginal melanoma: an updated Surveillance Epidemiology and End Results Database review, comparison with cutaneous melanoma and significance of racial disparities. Int J Gynecol Cancer 2013;23:1118–1125.CrossRefGoogle ScholarPubMed
Schiavone, MB, et al. Combined immunotherapy and radiation for treatment of mucosal melanomas of the lower genital tract. Gynecol Oncol Rep 2016;16:42–46.CrossRefGoogle ScholarPubMed
Salama, AKS, et al. Ipilimumab and radiation in patients with high risk resected or regionally advanced melanoma. Clin Cancer Res 2021;27(5):1287–1295.CrossRefGoogle ScholarPubMed
National Comprehensive Cancer Network. Melanoma: cutaneous (Version 1.2021). Available from: www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdfGoogle Scholar
Dummer, R, et al. Overall survival in patients with BRAF-mutant melanoma receiving encorafenib plus binimetinib versus vemurafenib or encorafenib (COLUMBUS): a multicenter, open-label, randomized, phase 3 trial. Lancet Oncol 2018;19:1315–1327.CrossRefGoogle ScholarPubMed
Wasif, N, et al. Does metastatectomy improve survival in patients with stage IV melanoma? A cancer registry analysis of outcomes. J Surg Oncol 2011;104:111–115.CrossRefGoogle Scholar

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