Abstract
To investigate the clinical characteristics and prognostic factors influencing overall survival (OS) in patients with primary female genital tract malignant melanoma (PFGMM). Methods Clinical data of 60 patients with PFGMM treated at Sichuan Cancer Hospital between 2014 and 2024 were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method and compared with the log-rank test. Variables with a P value < 0.05 in univariate analysis were included in the multivariate Cox proportional hazards model to identify independent prognostic factors. Results The 1-, 3-, and 5-year OS rates of patients with PFGMM were 73.3%, 53.3%, and 16.7%, respectively, with a median survival of 25 months. Univariate analysis indicated that menopausal status, surgery, chemotherapy, immunotherapy, and post-treatment recurrence were significantly associated with OS (all P < 0.05). Multivariate analysis identified age ≥ 55 years, presence of chronic comorbidities, tumor located in the lower or middle genital tract, menopausal status, and absence of chemotherapy or immunotherapy as independent adverse prognostic factors (all P < 0.05). Conclusion PFGMM is a rare and aggressive malignancy with poor long-term survival. Older age, menopausal status, tumor site, and lack of systemic therapy were independently associated with worse prognosis. Comprehensive treatment, including surgery combined with chemotherapy and immunotherapy, may improve patient outcomes.