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Wang X, Li J, Li Y, Lv M, Dong X, Fan Z, Guo T. Single-cell analysis of the cellular landscape of vulvar melanoma provides new insight for immunotherapy administration. BMC Cancer 2024; 24:101. [PMID: 38233802 PMCID: PMC10795381 DOI: 10.1186/s12885-024-11839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Vulvar and vaginal melanoma (VuM & VaM) is a rare gynecologic malignancy with high mortality but low effectiveness to checkpoint immunotherapy compared to cutaneous melanoma. This article aims to elucidate the role of the disordered immune microenvironment in cancer progression in VuM. METHODS At first, this article applied single-cell RNA sequencing (scRNA-seq) to the VuM obtained from a 68-year-old female patient, and constructed a single-cell atlas of VuM consist of 12,243 single cells. Then this article explores the genomic complexity and core signal channel in VuM microenvironment. RESULTS This article provides new insights about the pathogenesis of VuM based on single-cell resolution data. It was found that the activation of CD8+ T cell contributed to induce tumor angiogenesis and immune escape, and the activation of the antigen-presenting molecular function participated in melanoma metastasis. CONCLUSION This article provided new insights into underlining VuM molecular regulation and potential signaling involved in immunotherapy, which would benefit the clinical practice and administration.
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Affiliation(s)
- Xinqi Wang
- Key Laboratory of Bioresources and Eco-environment (Ministry of Education), College of Life Sciences, Sichuan University, 610065, Chengdu, Sichuan, China
| | - Jiahui Li
- Key Laboratory of Bioresources and Eco-environment (Ministry of Education), College of Life Sciences, Sichuan University, 610065, Chengdu, Sichuan, China
| | - Yifei Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China
| | - Mingyi Lv
- Key Laboratory of Bioresources and Eco-environment (Ministry of Education), College of Life Sciences, Sichuan University, 610065, Chengdu, Sichuan, China
| | - Xue Dong
- Ambulatory surgery Department, West China Second Hospital, Sichuan University, 610041, Chengdu, Sichuan, China
| | - Zhenxin Fan
- Key Laboratory of Bioresources and Eco-environment (Ministry of Education), College of Life Sciences, Sichuan University, 610065, Chengdu, Sichuan, China.
| | - Tao Guo
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China.
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Joste M, Dion L, Brousse S, Nyangoh Timoh K, Rousseau C, Reilhac A, Laviolle B, Lesimple T, Lavoue V, Leveque J. Vulvar and vaginal melanomas: A retrospective study spanning 19 years from a tertiary center. J Gynecol Obstet Hum Reprod 2021; 50:102091. [PMID: 33592345 DOI: 10.1016/j.jogoh.2021.102091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Mucosal melanomas (MM) of the female genital tract are rare a. We aimed to study the prognostic factors of vulvar and vaginal locations of MM. MATERIAL AND METHOD A multicenter, retrospective cohort study conducted between 01/01/2000 and 01/06/2019. RESULT Of the 33 patients included 25 (75.8 %) had vulvar (VuM) and eight (24.2 %) vaginal melanomas (VaM). VaMs were deeper: median Breslow index: 17.5mm [3.5-22] versus 4.3mm [0.35-18] (p=0.013). Average follow-up was 24.0±59.8 months. Twenty-six patients (78.8 %) experienced recurrence. Disease-free survival was 52.9 % at 1year (64.7 % for VuM and 14.3 % for VaM) and 8.4 % at 3 years (11 % for VuM and 0% for VaM) (p=0.002). Median time to the first recurrence was 9.01 months [CI95 %: 2.07-56.71]. VaM recurred earlier than VuM (3.12 months [CI95 %: 2.07-12.49] versus 17.72 [CI95 %: 3.58-56.71], p=0.011). VaM had a higher risk of recurrence (HR=5.64 [CI95 %: 2.01-15.82], p=0.001) in multivariate analysis. Overall survival was 88.5 % at 1year (100 % for VuM and 50 % for VaM), and 59.4 % at 3 years (69.3 % for VuM and 25 % for VaM). Women with VaM died earlier: median specific death occurrence of 8.76 months [CI95 %: 6.54-24.72] versus 39.61 [CI95 %: 21.89-209.21], p=0.013 (HR=5.08 [CI95 %: 1.39-18.60], p=0.014). A lesion size ≥3cm was associated with an increased risk of mortality (HR=8.45 [CI95 %: 1.60-44.52], p=0.012). In multivariate analysis, vaginal location remained an independent and predictive variable of a higher risk of specific death (HR=8.56 [CI95 %: 1.95-37.64], p=0.005). CONCLUSION A vaginal location of MM is associated with a poorer prognosis than a vulvar location.
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Affiliation(s)
- Marine Joste
- Gynecology Unit, CHU Rennes, 16 Bd de Bulgarie, BP 90 347, 35203, RENNES Cedex 2, France
| | - Ludivine Dion
- Gynecology Unit, CHU Rennes, 16 Bd de Bulgarie, BP 90 347, 35203, RENNES Cedex 2, France
| | - Susie Brousse
- Gynecology Unit, CHU Rennes, 16 Bd de Bulgarie, BP 90 347, 35203, RENNES Cedex 2, France
| | - Krystel Nyangoh Timoh
- Gynecology Unit, CHU Rennes, 16 Bd de Bulgarie, BP 90 347, 35203, RENNES Cedex 2, France
| | - Chloé Rousseau
- Clinical Pharmacology Unit, CHU Pontchaillou, 2 rue Henri Le Guilloux, BP 35 033, RENNES Cedex 9, France
| | - Astrid Reilhac
- Clinical Pharmacology Unit, CHU Pontchaillou, 2 rue Henri Le Guilloux, BP 35 033, RENNES Cedex 9, France
| | - Bruno Laviolle
- Clinical Pharmacology Unit, CHU Pontchaillou, 2 rue Henri Le Guilloux, BP 35 033, RENNES Cedex 9, France
| | - Thierry Lesimple
- Medical Oncology, CRLCC Centre Eugène Marquis, Avenue de la Bataille Flandre-Dunkerque, CS 44 229, 35042, RENNES Cedex 9, France
| | - Vincent Lavoue
- Gynecology Unit, CHU Rennes, 16 Bd de Bulgarie, BP 90 347, 35203, RENNES Cedex 2, France.
| | - Jean Leveque
- Gynecology Unit, CHU Rennes, 16 Bd de Bulgarie, BP 90 347, 35203, RENNES Cedex 2, France
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Abstract
ABSTRACT Melanomas of the female gynecological tract comprise approximately 18% of mucosal melanomas, a rare subtype of melanoma. Within the female genital tract, 70% of primary melanomas of the gynecological tract are from the vulva with the remainder occurring in the vagina and rarely, in the cervix. We investigate molecular alterations by next-generation sequencing-based molecular tests targeting 99 cancer genes and translocation/fusion assays in 4 and 3 vaginal melanomas, respectively. The ages of the 4 patients range from 65 to 90 years. Postmenopausal bleeding was the most common presenting symptom. Tumor size ranged from 0.5 to 6.6 cm. KIT L576P mutation was documented in case 1, whereas TP53 mutation was seen in cases 2 and 3 (L130F and Y163C). Case 2 also harbored NF2 E204Q and ATRX D1719H mutations. A number of gene copy alterations were noted in case 4, which included GNA11 loss, MYC gain, RET loss, SMO loss, SUFU loss, and TSC2 loss. No gene fusion was detected in any of the 3 tested cases. In conclusion, in addition to KIT, TP53, and ATRX mutations, which have been previously reported, our cases harbor NF2 mutation and multiple gene copy alterations that have not previously been documented in vaginal melanomas. These findings highlight the potential role of targeted therapy in this rare melanoma subtype.
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Cascella M, Muzio MR, Viscardi D, Cuomo A. Features and Role of Minimally Invasive Palliative Procedures for Pain Management in Malignant Pelvic Diseases: A Review. Am J Hosp Palliat Care 2016; 34:524-531. [PMID: 26936922 DOI: 10.1177/1049909116636374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Pain is a common and debilitating symptom in pelvic cancer diseases. Failure in controlling this pain through pharmacological approaches calls for employing multimodal management and invasive techniques. Various strategies are commonly used for this purpose, including palliative radiotherapy, epidural medications and intrathecal administration of analgesic and local anesthetic drugs with pumps, and neural or plexus blockade. This review focuses on the features of minimally invasive palliative procedures (MIPPs), such as radiofrequency ablation, laser-induced thermotherapy, cryoablation, irreversible electroporation, electrochemotherapy, microwave ablation, and cementoplasty as well as their role in palliation of cancer pelvic pain. Despite the evidence of effectiveness and safety of these interventions, there are still many barriers to accessing MIPPs, including the availability of trained staff, the lack of precise criteria of indication, and the high costs.
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Affiliation(s)
- Marco Cascella
- 1 Department of Anestesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Maria Rosaria Muzio
- 2 Division of Infantile Neuropsychiatry, UOMI-Maternal and Infant Health, Azienda Sanitaria Locale Napoli 3 Sud, Naples, Italy
| | - Daniela Viscardi
- 1 Department of Anestesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Arturo Cuomo
- 1 Department of Anestesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
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Abstract
Radical surgery is considered not to improve the prognosis of primary malignant melanoma of the vagina (PMMV). This study was carried out to review the general consensus. A systematic review was performed on the basis of data from 10 patients in our cohort and 147 patients in the previous literature. The radicality of the initial surgery (RAINS) score was defined as the total number of points in terms of the resected organs. The target organs were the vagina, vulva, urethra, bladder, uterus, anus, rectum, pelvic lymph nodes, and inguinal lymph nodes. Overall survival (OS) according to the RAINS score was analyzed using the Kaplan-Meier method. Information on tumor stage, size, and depth of invasion was not obtained in 15, 47, and 43% of patients, respectively. The median follow-up period was 18 months. OS with a RAINS score of at least 7 was significantly longer than that with a RAINS score of up to 6 (median survival time, 41 vs. 19 months; log-rank test, P=0.037), despite the fact that the former group included significantly more patients with advanced-stage disease. A significant difference in OS was not found between patients with a RAINS score of at least 6 and up to 5. The therapeutic significance of radical surgery for PMMV has not been assessed appropriately in previous studies because of the lack of comparability among groups and differences in the definitions of surgical radicality. Patients with PMMV might benefit from initial surgery with appropriate surgical radicality, despite incomplete validation of the RAINS score.
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Abstract
Melanoma of the female genital tract is a rare location (less than 2% of melanomas all sites combined). These cancers have a very poor prognosis, due to the delay in diagnosis. Vulvar location is about 1% of melanomas then the vaginal location, uterine and ovarian. There is no consensus to date regarding their care, due to the rarity of the lesions. Their treatment must however be based on the current data concerning gynaecological cancers as well as standard management of cutaneous melanoma. The treatment is often based on conservative surgery, because radical resection does not improve survival. For the vulva and vagina, reconstructive surgery is possible. Treatment is sometimes supplemented by chemotherapy or radiotherapy, which could improve local control. The interest in the use of targeted therapy in these locations is not well known because of their rarity, but the study of genes c-Kit and BRAF provides new prospects for treatment. The objective of this review is to describe and report the current state of knowledge about gynaecologic melanomas.
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Bennani A, el Fatemi H, Erraghay S, Mobakir H, Ameurtess H, Souuaf I, Moumna K, Idrissi K, Zriouel A, Squalli N, Banani A, Amarti A. [The primary melanoma of the female genital tract: report of three cases and review of literature]. Pan Afr Med J 2013; 16:58. [PMID: 24672629 PMCID: PMC3964009 DOI: 10.11604/pamj.2013.16.58.2404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/24/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Amal Bennani
- Service d'anatomie pathologique CHU Hassan II Fès, Maroc
| | | | | | - Hind Mobakir
- Service de gynécologie obstétrique CHU Hassan II Fès
| | | | - Ihsane Souuaf
- Service d'anatomie pathologique CHU Hassan II Fès, Maroc
| | - Kaoutar Moumna
- Service d'anatomie pathologique CHU Hassan II Fès, Maroc
| | - Karima Idrissi
- Service d'anatomie pathologique CHU Hassan II Fès, Maroc
| | | | | | | | - Affaf Amarti
- Service d'anatomie pathologique CHU Hassan II Fès, Maroc
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