A 60-year-old woman presents with a 2.5 cm darkly pigmented, raised lesion on the right labium majus with ipsilateral inguinal lymphadenopathy. Biopsy confirms malignant melanoma with a Breslow thickness of 3.2 mm. What is the most important prognostic factor?
- A Presence of inguinal lymph node metastasis ✓
- B Lesion size greater than 2 cm
- C Lesion location on the labium majus
- D Breslow thickness of 3.2 mm
Correct answer: A. Presence of inguinal lymph node metastasis
Explanation
In vulvar melanoma, inguinal lymph node status is the single most important prognostic factor for survival, similar to cutaneous melanoma. While Breslow thickness guides primary management and sentinel lymph node biopsy, the presence or absence of nodal disease is the strongest determinant of overall survival and directly influences staging and adjuvant therapy decisions.
Reference: Comprehensive Gynecology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.