Urethral involvement is associated with higher mortality and local recurrence in vulvar melanoma: a single institutional experience.

Abstract Vulvar malignant melanoma (VMM), although uncommon, comprises 5-10% of all vulvar malignancies. Local control is notoriously poor in VMM with recurrence rates of 30-50% compared to approximately 3% in cutaneous melanomas. We studied clinicopathologic features of 37 women with VMM, after reviewing three decades of clinical follow up data in our institutional databases. Most patients were Caucasian (n=35) with an average age at diagnosis of 60.6 years (range 23-83). The most common subtype was mucosal lentiginous melanoma (n=25). We compared Kaplan-Meier survival curves of 31 patients defined by clinical and microscopic attributes using exact log-rank tests. Younger patients at diagnosis (23-64 yo), those with thin melanomas ( 1mm) and those with Clark's level II or III tumors had better 5 year survival rates than older patients (65-83 yo), and those with thick melanomas (>1mm) and those with Clark's level IV or V (p