Highlights
- •A 31-gene genetic expression profile (31-GEP) was developed to predict outcome in cutaneous melanoma (CM) patients.
- •Recurrence rates were higher for Class 2 vs Class 1 patients and highest in patients who were Class 2 and SNB positive.
- •Both AJCC stage and GEP class were independently predictive of both RFS and DMF.
- •GEP Class independently predicted relapse in AJCC “low risk” (stages IA-IIA) patients.
- •31-GEP adds prognostic information in the evaluation of primary CM and should be considered in patents referred for SNB.
Abstract
Background
A 31-gene genetic expression profile (31-GEP; Class 1 = low risk, Class 2 = high risk)
developed to predict outcome in cutaneous melanoma (CM) has been validated by retrospective,
industry-sponsored, or small series.
Methods
Tumor features, sentinel node biopsy (SNB) results, and outcomes were extracted from
a prospective database of 383 C M patients who underwent SNB and had a 31-GEP run
on their primary tumor. Groups were compared by uni- and multi-variable analysis.
Relapse-free and distant metastasis-free survival (RFS, DMFS) were estimated by Kaplan-Meier
method.
Results
Breslow thickness, T stage, and SNB positivity were significantly higher in Class
2 patients. Recurrence rates were higher for Class 2 vs Class 1 patients and highest
in patients who were Class 2 and SNB positive. GEP class was predictive of RFS and
DMFS and independently predicted relapse in AJCC “low risk” (stages IA-IIA) patients.
Conclusions
31-GEP adds prognostic information in CM patents undergoing SNB.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Melanoma epidemiology, biology and prognosis.Eur J Canc. 2013; 11: 81-91
- Cutaneous melanoma: from pathogenesis to therapy (Review).Int J Oncol. 2018; 52: 1071-1080
- Prognostic value of low tumor burden in patients with melanoma.Oncology. 2018; 32: e90-e96
- Melanoma staging: American Joint committee on cancer (AJCC) 8th edition and beyond.Ann Surg Oncol. 2018; 25: 2105-2110
- Spotlight on the utility of the Oncotype DX breast cancer assay.Int J Womens Health. 2018; 10: 89-100
- Development of a prognostic genetic signature to predict the metastatic risk associated with cutaneous melanoma.Clin Canc Res. 2015; 21: 175-183
- Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy.J Am Acad Dermatol. 2015; 72: 780-785
- Performance of a prognostic 31-gene expression profile in an independent cohort of 523 cutaneous melanoma patients.BMC Canc. 2018; 18: 130-141
- Identification of patients at risk of metastasis using a prognostic 31-gene expression profile in subpopulations of melanoma patients with favorable outcomes by standard criteria.J Am Acad Dermatol. 2019; 80: 149-157
- Estimation of prognosis in invasive cutaneous melanoma: an independent study of the accuracy of a gene expression profile test.Dermatol Surg. 2018; 44: 1494-1500
- Molecular risk prediction in cutaneous melanoma: a meta-analysis of the 31-gene expression profile prognostic test in 1,479 patients.J Am Acad Dermatol. 2020; 83: 745-753
- Interim analysis of survival in a prospective, multi-center registry cohort of cutaneous melanoma tested with a prognostic 31-gene expression profile test.J Hematol Oncol. 2017; 10: 152-160
- Prospective validation of the prognostic 31-gene expression profiling test in primary cutaneous melanoma.Cancer Med. 2019; 8: 2205-2212
- Early outcome of a 31-gene expression profile test in 86 AJCC stage IB-II melanoma patients. A prospective multicentre cohort study.J Eur Acad Dermatol Venereol. 2019; 33: 857-862
- Clinicopathologic predictors of sentinel lymph node metastasis in thin melanoma.J Clin Oncol. 2013; 31: 4387-4393
- NCCN clinical practice guidelines in oncology: melanoma. NCCN.(Version 1.2019 — November 1) (Oct 12th, 2020)
- Nonvisualized sentinel lymph nodes on lymphoscintigraphy in melanoma: predictive factors and surgical outcomes.Nucl Med Commun. 2017; 38: 383-387
- (Available at:) (June 15th, 2020)
- Nonparametric estimation from incomplete observations.J Am Stat Assoc. 1958; 53 (81): 457
- Brief report in melanoma incidence in ontario.J Cutan Med Surg. 2018; 22: 476-478
- Melanoma survival in the United States, 1992 to 2005.American Academy of Dermatology. 2011; 65: 78-86
- Genetics of melanoma.Front Genet. 2013; 3: 330
- Distinct sets of genetic alterations in melanoma.N Engl J Med. 2005; 53: 2135-2147
- The evolution of paradigms for the management of breast cancer: a personal perspective.Canc Res. 1992; 52: 2371-2383
- Guidance of sentinel node biopsy decisions in patients with T1-2 melanoma using gene expression profiling.Future Oncol. 2019; 15: 1207-1217
- Should sentinel lymph node biopsy be performed for all T1b melanomas in the new 8(th) Edition American Joint Committee on Cancer Staging System?.J Am Coll Surg. 2019; 228: 466-472
Article info
Publication history
Published online: March 17, 2021
Accepted:
March 13,
2021
Received in revised form:
February 20,
2021
Received:
November 8,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
