Prognostic factors in melanoma

SummaryBackgroundThere are clinical and pathological factors associated with the clinical course of melanoma. These parameters allow us to predict survival times and establish a course of treatment.AimThe aim of the study was to assess the significance of immunohistochemical markers in the progression of melanoma, and relate these findings to the influence of clinical and histological factors on survival time.Materials/MethodsIn this study, archival histological material obtained from 50 melanoma patients operated on in the Great Poland Cancer Centre between 1990–1995 was analysed. Using immunohistochemistry we detected the presence of markers known to be important in the diagnosis of melanoma, including: HMB-45, PCNA, Ki-67, MMP-2, CD44 and nm23. Following this, univariate logistic regression was performed and clinical, histopathological and immunohistochemical data of statistical significance were correlated with survival time using the Cox nonparametric proportional hazard regression model.ResultsThe results suggested that the most important prognostic factors correlating with survival time were: the presence of nm23 antigen (p = 0.0342) and the thickness of the melanoma, as measured by the Breslow method in mm (p = 0.0191). According to the univariate analysis there were correlations between patient death or survival and the histological type, Superficial Spreading Melanoma Malignum (SSMM) (p = 0.0187), regional lymphatic metastases (p = 0.0030) and positive Ki-67 results (p = 0.0282).ConclusionsTaken together, our results allowed us to conclude (a) that there was a correlation between survival time and nm23 antigen expression and the thickness of melanoma, as measured by the Breslow method in mm, (b) that there were correlations between patient survival or death and the histological type of Superficial Spreading Melanoma Malignum, regional lymphatic metastases and positive Ki-67, (c) that other parameters (age, gender, anatomical location of the melanoma, the presence of ulceration, lymphatic infiltration, the existence of satellites, and positive PCNA and MMP-2) showed no significant influence on survival