Molecular Staging in Stage II and III Melanoma Patients and Its Effect on Long-Term Survival

Voit, Christiane; Kron, Martina; Rademaker, J.; Schwürzer-Voit, Markus; Sterry, Wolfram; Weber, Lutz; Özdemir, Cueneyt; Proebstle, Thomas M.; Keilholz, Ulrich

doi:10.1200/jco.2005.04.098

Cited by 44 publications

(34 citation statements)

References 37 publications

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“…Of more use has been the detection of biochemical and molecular markers in circulating tumor cells in the blood, especially for melanoma. Recently, detection of tyrosinase in circulating tumor cells of peripheral blood showed a strong association with disease-specific survival time in stage II and III disease (39). A similar result was obtained in the current study using Mitf as the biomarker.…”

Section: Markers Of Melanoma and Host Survivalsupporting

confidence: 91%

Microphthalmic-associated transcription factor integrates melanocyte biology and melanoma progression.

Goding

Meyskens

2006

Clinical Cancer Research

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Section: Markers Of Melanoma and Host Survivalsupporting

confidence: 91%

Microphthalmic-associated transcription factor integrates melanocyte biology and melanoma progression.

Goding

Meyskens

2006

Clinical Cancer Research

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“…However, CTC detection rates were remarkably similar across TNM stages (range 32-47.4%) and significantly different from those one would expect based on the survival rates observed in patients with different stages of disease ( Fig. 3; (29,36,45,53,57,58,64), the authors analyzed both OS and PFS.…”

Section: Ctc Prognostic Valuementioning

confidence: 65%

The Prognostic Value of Circulating Tumor Cells in Patients with Melanoma: A Systematic Review and Meta-analysis

Mocellin

Hoon

Ambrosi

et al. 2006

Clinical Cancer Research

199

151

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Background: The detection of circulating tumor cells (CTC) in patients with melanoma represents an appealing prognostic tool, but no consensus exists on this topic. We aimed to comprehensively and quantitatively summarize the evidence for the use of CTC to predict patients'clinical outcome. Methods: Fifty-three studies enrolling 5,433 patients were reviewed. Correlation of CTC status with tumor-node-metastasis disease stage and patients'overall (OS) and progression-free (PFS) survival was assessed by means of association statistics and meta-analysis, respectively. Results: CTC status correlated with both tumor-node-metastasis stage (stage I, 32%; stage II, 41.7%; stage III, 41.1%; stage IV, 47.4%; P trend < 0.0001) and survival (OS: hazard ratio, 2.42; 95% confidence interval, 1.7-3.45, P < 0.0001; PFS: hazard ratio, 2.45; 95% confidence interval, 1.78-3.38; P < 0.0001). However, statistical heterogeneity was significant for both OS and PFS, likely underscoring the wide variability in study design. Furthermore, CTC positivity rates in early stages were higher and in the metastatic setting were lower than expected, which indicates an unsatisfactory accuracy of currently available CTC detection assays. Conclusions: Our findings suggest that CTC might have a clinically valuable prognostic power in patients with melanoma. However, the heterogeneity of the studies thus far published warrants caution not to overestimate the favorable results of pooled data.

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“…Such analyses could lead to the establishment of nomograms providing more individualized prognostic profiles (49 The value of reverse transcription-PCR to detect submicroscopic disease in the SLN or in the blood (ref. 50; not discussed in this article) requires more extensive studies to establish standard techniques, defining the most reliable PCR targets along with long-term follow-up before such staging endeavors can be incorporated in the routine risk assessment process. The evolving technology of microarray analysis offers exciting prospects for the future not only to establish more definitive and individualized prognosis but also to provide predictions of response to particular therapies.…”

Section: Discussionmentioning

confidence: 99%

Early-Stage Melanoma: Staging Criteria and Prognostic Modeling

Ross¹

2006

Clinical Cancer Research

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Accurate risk assessment is central to the process of making rational surgical and systemic treatment recommendations for melanoma patients and in establishing appropriate clinical trial stratification criteria. The current American Joint Commission on Cancer melanoma staging system incorporated relevant prognostic variables to provide a framework for the estimation of risk for recurrence; however, significant prognostic heterogeneity exists within the stage groupings. In the stage I/II group, survival rates range from 40% to 95% as defined by the combination of tumor thickness and ulceration. The use of novel prognostic factors, such as mitotic rate, sentinel node biopsy, and prognostic modeling using a variety of factors, can minimize this prognostic heterogeneity and provide a more accurate and individualized prognostic profile. Recent modifications in the stage III criteria include the number of positive nodes, whether the nodal disease is microscopic or clinically apparent, and the presence of an ulcerated primary. Through these factors, survival estimates can be provided, but like the stage I/II group, wide ranges in prognosis exist. The complexion of the stage III population is in evolution as a result of increasing numbers of patients being diagnosed as having microscopic sentinel node disease. Contemporary efforts are focused on defining the prognosis and natural history of this group.Through prognostic modeling using the number of nodes involved, ulceration status, and a measure of disease burdenödisease in the sentinel nodeörelatively homogeneous subgroups can be identified. Long-term follow-up of patients staged with PCR molecular techniques on sentinel nodes shows conflicting value in assessing prognosis and therefore cannot be routinely used outside a clinical trial. The combination of genomic profiling using microarray analyses and the development of targeted therapy holds the future promise of individualizing prognosis and therapy.

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Molecular Staging in Stage II and III Melanoma Patients and Its Effect on Long-Term Survival

Cited by 44 publications

References 37 publications

Microphthalmic-associated transcription factor integrates melanocyte biology and melanoma progression.

Microphthalmic-associated transcription factor integrates melanocyte biology and melanoma progression.

The Prognostic Value of Circulating Tumor Cells in Patients with Melanoma: A Systematic Review and Meta-analysis

Early-Stage Melanoma: Staging Criteria and Prognostic Modeling

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