Serum markers lactate dehydrogenase and S100B predict independently disease outcome in melanoma patients with distant metastasis

Abstract

Background:Established prognostic factors are of limited value to predict long-term survival and benefit from metastasectomy in advanced melanoma. This study aimed to identify prognostic factors in patients with distant metastasis.Methods:We analysed overall survival of 855 institutional melanoma patients with distant metastasis by bivariate Kaplan–Meier survival probabilities and multivariate Cox hazard regression analysis.Results:Serum lactate dehydrogenases (LDH), S100B, the interval between initial diagnosis and occurrence of distant metastasis, the site of distant metastases, and the number of involved distant sites were significant independent prognostic factors in both bivariate and multivariate analyses. Visceral metastases other than lung (hazard ratio (HR) 1.8), elevated S100B (HR 1.7) and elevated LDH (HR 1.6) had the highest negative impact on survival. Complete metastasectomy was likewise an independent prognostic factor in multivariate analysis. This treatment was associated with favourable survival for patients with normal LDH and S100B values (5-year survival, 37.2%).Conclusion:The serum markers LDH and S100B were both found to be prognostic factors in melanoma patients with distant metastasis. Furthermore, complete metastasectomy had an independent favourable prognostic impact in particular for the patient subgroup with normal LDH and S100B values.

Increased CCL17 serum levels are associated with improved survival in advanced melanoma

“…These biomarkers were more as in the subgroup of stage I to stage III patients (hazard ratio 2.28; p < 0.0001) independent from other prognostic factors. In prior studies, we demonstrated that S100B and LDH had independent impact on prognosis of patients with distant metastasis and the combined analysis of both markers might be used to select patients for metastasectomy [7,8]. However, despite this large evidence, no worldwide consensus exists on its implementation in the routine clinical setting in melanoma patients.…”

1009 Serum lactate dehydrogenase and survival following cancer diagnosis

“…Similar associations with survival have been established in chronic myeloid and lymphocytic leukaemias (Weinberg et al, 2007;Goldaniga et al, 2008) and small cell lung cancer (SCLC) (You et al, 2008;Danner et al, 2010). In recent clinical trials, elevated serum LDH has been shown as an independent predictor of overall survival in advanced or metastatic cancer of the breast (Brown et al, 2012), prostate (Scher et al, 2009;Gravis et al, 2014), colorectum (Bar et al, 2014), oesophagus (Polee et al, 2003), pancreas (Tas et al, 2001), ovary (Schneider et al, 1998), nasopharynx (Jin et al, 2013), gastric adenocarcinoma (Sougioultzis et al, 2011), hepatocellular carcinoma (HCC) (Faloppi et al, 2014), renal cell carcinoma (Armstrong et al, 2012) and melanoma (Balch et al, 2004;Weide et al, 2012). The inverse association with overall survival in solid tumours were shown in a recent meta-analysis, with HR for overall death of 1.7 (95% CI: 1.62-1.79) (Petrelli et al, 2015).…”

Vemurafenib

“…Weide et al assessed the use of biomarker in melanoma patients with distant metastases. Serum markers LDH and S100B were found to be independent prognostic factors in melanoma patients with distant metastases, and both factors were associated with similar hazard ratios (Weide et al 2012).…”