Guangwen Yuan, Bing Li, Jusheng An

Department of Gynecologic Oncology, Cancer Hospital of Peking union   Medical College and Chinese Academy of Medical Science

Objective: Primary malignant melanoma of the cervix is an extremely rare disease and exhibits poor long-term survival. Here we present the largest single center study that investigated the clinical characteristics and prognosis of primary cervical malignant melanoma. Methods:Clinical data from 14 patients treated for primary malignant melanoma of the cervix at the Cancer Hospital of Chinese Academy of Medical Science between January 1981 and December 2014 were retrospectively analyzed. Results: The median age of patients was 59.5 years (range of 42 to 77 years) and all patients presented with the symptom of vaginal bleeding. Ten patients received surgery while the other four were only treated with chemotherapy and/or radiotherapy. Two patients also received immunotherapy post surgery. Twelve (85.7%, 12/14) patients developed recurrence and eleven patients (78.6%, 11/14) died of the disease. The mean survival time of patients who received surgery and without surgery were 41.9 and 7.75 months, respectively (P=0.061).We found that six patients who received radical hysterectomy and pelvic lymph-node dissection had longer survival than four patients who received total hysterectomy with or without lymph-node dissection (33.0 months vs 20.5 months, P=0.015). The median overall survival (OS) of the patients in stage I, II and III were 25.0 months, 24.0 months and 10.0 months (P=0.539)and the two years overall survival rate of each stage were 60.0%(3/5), 50.0%(3/6) and 0.0%(0/3), respectively. Conclusion:Patients with primary malignant melanoma of the cervix have a poor prognosis and radical hysterectomy and pelvic lymph-node dissection offers better prognosis.

Keywords: Malignant melanoma, treatment, cervix, prognosis, radical hysterectomy