Multivariate analysis of prognostic factors in patients with nodular melanoma

Susok, Laura; Stücker, Markus; Bechara, Falk G.; Stockfleth, Eggert; Gambichler, Thilo

doi:10.1007/s00432-021-03562-1

Cited by 11 publications

(11 citation statements)

References 23 publications

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“…This, in fact, seems like a surprising finding, since the presence of DCD expression was also associated with a more favorable course of disease. As patients with NM and ALM subtypes often present with prognostically unfavorable tumors, one would have expected a different result (Susok and Gambichler 2021 ; Susok et al 2021 ). However, this finding could be partly explained by the proportion of patients with LMM having a relatively good prognosis.…”

Section: Discussionmentioning

confidence: 99%

Protein expression of prognostic genes in primary melanoma and benign nevi

Gambichler

Elfering

Meyer

et al. 2021

J Cancer Res Clin Oncol

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Purpose To evaluate the protein expression characteristics of genes employed in a recently introduced prognostic gene expression assay for patients with cutaneous melanoma (CM). Methods We studied 37 patients with CM and 10 with benign (melanocytic) nevi (BN). Immunohistochemistry of primary tumor tissue was performed for eight proteins: COL6A6, DCD, GBP4, KLHL41, KRT9, PIP, SCGB1D2, SCGB2A2. Results The protein expression of most markers investigated was relatively low (e.g., DCD, KRT9, SCGB1D2) and predominantly cytoplasmatic in melanocytes and keratinocytes. COL6A6, GBP4, and KLHL41 expression was significantly enhanced in CM when compared to BN. DCD protein expression was significantly correlated with COL6A6, GBP4, and KLHL41. GBP4 was positively correlated with KLHL41 and inversely correlated with SCGB2B2. The latter was also inversely correlated with serum S100B levels at time of initial diagnosis. The presence of SCGB1D2 expression was significantly associated with ulceration of the primary tumor. KRT9 protein expression was significantly more likely found in acral lentiginous melanoma. The presence of DCD expression was less likely associated with superficial spreading melanoma subtype but significantly associated with non-progressive disease. The absence of SCGB2A2 expression was significantly more often observed in patients who did not progress to stage III or IV. Conclusions The expression levels observed were relatively low but differed in part with those found in BN. Even though we detected some significant correlations between the protein expression levels and clinical parameters (e.g., CM subtype, course of disease), there was no major concordance with the protective or risk-associated functions of the corresponding genes included in a recently introduced prognostic gene expression assay.

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Section: Discussionmentioning

confidence: 99%

Protein expression of prognostic genes in primary melanoma and benign nevi

Gambichler

Elfering

Meyer

et al. 2021

J Cancer Res Clin Oncol

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“…8 Moreover, a German single-center analysis observed that NM per se was not a significant independent predictor for disease recurrence or survival and was not associated with other unfavorable prognostic factors, including the absence of regression. 9 The epidemiological characteristics of ALMs are different from those of other types of cutaneous melanomas. ALM occurs more frequently in certain ethnic groups, such as blacks, Hispanics, and Asians, than in white-skinned persons (less than 5%).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…1,2 The prognostic value of histologic subtype in cutaneous melanoma patients is controversial, with divergent results in many studies. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] The prognostic influence of histologic subtype is usually weaker than that of other major predictors, such as tumor depth, ulceration, mitotic rate, and age. Therefore, our aim was to investigate the role of melanoma histology subtypes on survival using data from a tertiary cancer center in Turkey.…”

Section: Introductionmentioning

confidence: 99%

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Major Histotypes in Skin Melanoma: Nodular and Acral Lentiginous Melanomas Are Poor Prognostic Factors for Relapse and Survival

Taş

Ertürk

2022

The American Journal of Dermatopathology

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The histological subtype is not considered one of the major prognostic factors in melanoma, yet it is known to have an impact on survival. The aim of this study was to investigate the clinical significance of histological subtypes and the possible impacts of clinicopathological factors on the course of melanoma patients of all stages. A total of 1017 cutaneous melanoma patients were analyzed retrospectively. Four major melanoma histotypes that were studied in this study were as follows: (1) superficial spreading melanoma (SSM), (2) nodular melanoma (NM), (3) acral lentiginous melanoma (ALM), and (4) lentigo maligna melanoma (LMM). Unlike SSMs and LMMs, there were statistically significant correlations between NMs and ALMs and most aggressive histopathological prognostic indicators, such as higher Clark level (P = 0.0001), thick Breslow depth (P = 0.0001), presence of ulceration (P = 0.0001), and lymphovascular invasion (P = 0.0001). Furthermore, NMs and ALMs were also associated with advanced clinical stages, that is, node involvement and metastasis. Relapse rates for nonmetastatic melanomas were higher in NMs (39.6%) and ALMs (35.3%) than in SSMs (24.3%) and LMMs (10.3%) (P = 0.0001). Additionally, 5-year relapse-free survival rates were 90.5%, 70.5%, 55.7%, and 50.5% in LMMs, SSMs, ALMs, and NMs, respectively (P = 0.0001). Moreover, 5-year overall survival rates plummeted from 84.3% in LMMs to 74.8%, 64.3%, and 46% in SSMs, ALMs, and NMs, respectively (P = 0.0001). In conclusion, we observed that the histologic subtype was an independent predictor for relapse and outcome for cutaneous melanoma patients. Both NM and ALM had unfavorable prognoses, and they were associated with known poor pathological and clinical indicators.

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“…In univariable analysis, nodular melanoma was found to have the lower OS. This is mainly due to its vertical growth pattern with a rapidly increasing Breslow depth [ 23 ]. Worst OS is confirmed for nodular melanoma also in multivariable analysis when adjusted to age and sex.…”

Section: Discussionmentioning

confidence: 99%

Melanoma of the Scalp and Neck: A Population-Based Analysis of Survival and Treatment Patterns

Scampa

Mégevand

Viscardi

et al. 2022

Cancers

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Introduction: Melanoma is an aggressive skin cancer. Large demographic and clinic-pathologic studies are required to identify variations of tumour behavior. The aim of our study was to offer updated epidemiologic data on the scalp and neck melanoma with an overall survival analysis. Method: The SEER database was searched for all scalp and neck melanoma in adult patients between 2000 and 2019. Demographic and clinic-pathologic variables were described. Their impact on overall survival was assessed with the log-rank test after Kaplan–Meier model. A multivariable cox-regression was conducted to identify predictors of decreased survival. A p-value of <0.005 was considered statistically significant. Results: 20,728 Melanomas of the scalp and neck were identified. Mean age was 62.5 years. Gender ratio was 76.3% males. 79% of the tumours were localized at diagnosis. Increasing age, male gender, tumour ulceration, high mitotic rate or nodular subtype were independent prognostic factors of decreased overall survival. Surgery with less than 1 cm margin is associated with the best overall survival in this cohort. No significant difference in OS was seen between less than 1 cm and 1 to 2 cm margins. Conclusion: Knowledge of negative prognostic factors might help identify subgroups at risk and adapt their oncologic treatment.

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Multivariate analysis of prognostic factors in patients with nodular melanoma

Cited by 11 publications

References 23 publications

Protein expression of prognostic genes in primary melanoma and benign nevi

Protein expression of prognostic genes in primary melanoma and benign nevi

Major Histotypes in Skin Melanoma: Nodular and Acral Lentiginous Melanomas Are Poor Prognostic Factors for Relapse and Survival

Melanoma of the Scalp and Neck: A Population-Based Analysis of Survival and Treatment Patterns

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