C. Rowe, F. Tang, M.C. Hughes, M. Rodero, M. Malt,D. Lambie, A. Barbour, N. Hayward, B.M. Smithers,A. Green, K. Khosrotehrani
While sentinel lymph node status is a valu-able prognostic marker for cutaneous melanoma, it isassociated with signiﬁcant cost and potential morbidity.Additionally, the majority of patients that undergo this pro-cedure will have a negative result. We aimed to assess thecombined predictive value of established prognosticbiomarkers with clinical parameters in a cohort of highrisk melanoma patients, comparing their predictive powerto SLN status.
Tumour samples were obtained from patientswith stage IB and II melanomas undergoing sentinellymph node biopsy at the Princess Alexandra Hospitalbetween 1998 and 2007. Disease progression data wasobtained prospectively and information on death was fur-ther validated through the National Death Index. Estab-lished protein biomarkers (Ki67, p16, and CD163) wereassessed using immunohistochemistry. Models were gen-erated using multivariate survival analysis for both dis-ease-free and melanoma-speciﬁc survival.
189 patients with available tumour samples wereanalysed. Average Breslow thickness was 2.5 mm. 32(17%) patients died from melanoma during the follow-upperiod. A model resulting in a prognostic score incorporat-ing validated protein biomarkers and clinicopathologicalfactors was strongly predictive of survival, independent ofsentinel node status. The score allowed further classiﬁca-tion of risk of death from melanoma in sentinel node nega-tive patients.
The combination of clinicopathological fac-tors and established biomarkers can allow better predictionof outcome in stage IB and II melanoma. Further, theseprotein biomarkers are previously-validated, simple to useand are already used routinely in pathology laboratories,allowing this approach to be implemented immediately formelanoma patients.