Aaron W Kangas-Dick1,2, Alissa Greenbaum3, Victor Gall3, Roman Groisberg4, Janice Mehnert4, Chunxia Chen5, Dirk F Moore5,6, Adam C Berger3, Vadim Koshenkov3. 1. Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey (CINJ), New Brunswick, NJ, USA. ak1777@cinj.rutgers.edu. 2. Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA. ak1777@cinj.rutgers.edu. 3. Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey (CINJ), New Brunswick, NJ, USA. 4. Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 5. Division of Biometrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 6. Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
Abstract
BACKGROUND: A significant proportion of deaths from cutaneous melanoma occur among patients with an initial diagnosis of stage 1 or 2 disease. The Decision-Dx Melanoma (DDM) 31-gene assay attempts to stratify these patients by risk of recurrence. This study aimed to evaluate this assay in a large single-institution series. METHODS: A retrospective chart review of all patients who underwent surgery for melanoma at a large academic cancer center with DDM results was performed. Patient demographics, tumor pathologic characteristics, sentinel node status, gene expression profile (GEP) class, and recurrence-free survival (RFS) were reviewed. The primary outcomes were recurrence of melanoma and distant metastatic recurrence. RESULTS: Data from 361 patients were analyzed. The median follow-up period was 15 months. Sentinel node biopsy was performed for 75.9% (n = 274) of the patients, 53 (19.4%) of whom tested positive. Overall, 13.6% (n = 49) of the patients had recurrence, and 8% (n = 29) had distant metastatic recurrence. The 3- and 5-year RFS rates were respectively 85% and 75% for the class 1A group, 74% and 47% for the class 1B/class 2A group, and 54% and 45% for the class 2B group. Increased Breslow thickness, ulceration, mitoses, sentinel node biopsy positivity, and GEP class 2B status were significantly associated with RFS and distant metastasis-free survival (DMFS) in the univariate analysis (all p < 0.05). In the multivariate analysis, only Breslow thickness and ulceration were associated with RFS (p < 0.003), and only Breslow thickness was associated with DMFS (p < 0.001). CONCLUSION: Genetic profiling of cutaneous melanoma can assist in predicting recurrence and help determine the need for close surveillance. However, traditional pathologic factors remain the strongest independent predictors of recurrence risk.
BACKGROUND: A significant proportion of deaths from cutaneous melanoma occur among patients with an initial diagnosis of stage 1 or 2 disease. The Decision-Dx Melanoma (DDM) 31-gene assay attempts to stratify these patients by risk of recurrence. This study aimed to evaluate this assay in a large single-institution series. METHODS: A retrospective chart review of all patients who underwent surgery for melanoma at a large academic cancer center with DDM results was performed. Patient demographics, tumor pathologic characteristics, sentinel node status, gene expression profile (GEP) class, and recurrence-free survival (RFS) were reviewed. The primary outcomes were recurrence of melanoma and distant metastatic recurrence. RESULTS: Data from 361 patients were analyzed. The median follow-up period was 15 months. Sentinel node biopsy was performed for 75.9% (n = 274) of the patients, 53 (19.4%) of whom tested positive. Overall, 13.6% (n = 49) of the patients had recurrence, and 8% (n = 29) had distant metastatic recurrence. The 3- and 5-year RFS rates were respectively 85% and 75% for the class 1A group, 74% and 47% for the class 1B/class 2A group, and 54% and 45% for the class 2B group. Increased Breslow thickness, ulceration, mitoses, sentinel node biopsy positivity, and GEP class 2B status were significantly associated with RFS and distant metastasis-free survival (DMFS) in the univariate analysis (all p < 0.05). In the multivariate analysis, only Breslow thickness and ulceration were associated with RFS (p < 0.003), and only Breslow thickness was associated with DMFS (p < 0.001). CONCLUSION: Genetic profiling of cutaneous melanoma can assist in predicting recurrence and help determine the need for close surveillance. However, traditional pathologic factors remain the strongest independent predictors of recurrence risk.
Authors: Michael A Marchetti; Edmund K Bartlett; Stephen W Dusza; Christopher K Bichakjian Journal: J Am Acad Dermatol Date: 2018-12-23 Impact factor: 11.527
Authors: Pedram Gerami; Robert W Cook; Jeff Wilkinson; Maria C Russell; Navneet Dhillon; Rodabe N Amaria; Rene Gonzalez; Stephen Lyle; Clare E Johnson; Kristen M Oelschlager; Gilchrist L Jackson; Anthony J Greisinger; Derek Maetzold; Keith A Delman; David H Lawson; John F Stone Journal: Clin Cancer Res Date: 2015-01-01 Impact factor: 12.531
Authors: Michael D Onken; Lori A Worley; Devron H Char; James J Augsburger; Zelia M Correa; Eric Nudleman; Thomas M Aaberg; Michael M Altaweel; David S Bardenstein; Paul T Finger; Brenda L Gallie; George J Harocopos; Peter G Hovland; Hugh D McGowan; Tatyana Milman; Prithvi Mruthyunjaya; E Rand Simpson; Morton E Smith; David J Wilson; William J Wirostko; J William Harbour Journal: Ophthalmology Date: 2012-04-21 Impact factor: 12.079
Authors: Charles M Balch; Jeffrey E Gershenwald; Seng-Jaw Soong; John F Thompson; Michael B Atkins; David R Byrd; Antonio C Buzaid; Alistair J Cochran; Daniel G Coit; Shouluan Ding; Alexander M Eggermont; Keith T Flaherty; Phyllis A Gimotty; John M Kirkwood; Kelly M McMasters; Martin C Mihm; Donald L Morton; Merrick I Ross; Arthur J Sober; Vernon K Sondak Journal: J Clin Oncol Date: 2009-11-16 Impact factor: 44.544
Authors: Adam C Berger; Robert S Davidson; J Kevin Poitras; Indy Chabra; Richard Hope; Amy Brackeen; Clare E Johnson; Derek J Maetzold; Brooke Middlebrook; Kristen M Oelschlager; Robert W Cook; Federico A Monzon; Alexander R Miller Journal: Curr Med Res Opin Date: 2016-06-03 Impact factor: 2.580
Authors: Jennifer Keller; Theresa L Schwartz; Jason M Lizalek; Ea-Sle Chang; Ashaki D Patel; Maria Y Hurley; Eddy C Hsueh Journal: Cancer Med Date: 2019-04-05 Impact factor: 4.452
Authors: Saman S Ahmadian; Ian J Dryden; Andrea Naranjo; Angus Toland; Romain A Cayrol; Donald E Born; Peter S Egbert; Ryanne A Brown; Prithvi Mruthyunjaya; Jonathan H Lin Journal: Ocul Oncol Pathol Date: 2022-03-11