title: Association between molecular detection of GAGE and survival in patients with malignant melanoma: a retrospective cohort study.
abstract: We used GAGE as a molecular marker to identify melanoma cells with metastatic potential in the peripheral blood and the bone marrow. One hundred thirty-three patients with malignant melanoma (21 clinical stage II, 74 stage III, and 38 stage IV) had a single marrow and/or blood sample drawn immediately prior to surgical resection. Simultaneous bone marrow and blood samples (85 patients), marrow-only samples (35 patients), and blood-only samples (13 patients) were examined for the presence of GAGE expression using reverse transcription-PCR. GAGE expression was associated with adverse overall patient survival, measured from the time of sampling (P = 0.01). When data were stratified for clinical stage, median survival was statistically longer among GAGE-negative patients in the stage III cohort only (P = 0.01). In a multivariate model, only GAGE positivity in blood and/or marrow and clinical stage were significant prognostic variables. It was the detection of GAGE in blood but not marrow that was associated with poor survival. The detection of blood GAGE by reverse transcription-PCR has significant adverse implications for overall survival of patients with malignant melanoma in this cohort, and it warrants further investigation.
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: I Y
authors.initials: IY
authors.lastname: Cheung
authors.forename: N K
authors.initials: NK
authors.lastname: Cheung
authors.forename: R A
authors.initials: RA
authors.lastname: Ghossein
authors.forename: J M
authors.initials: JM
authors.lastname: Satagopan
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharya
authors.forename: D G
authors.initials: DG
authors.lastname: Coit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm; D001853:Bone Marrow / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000097:blood / Q000378:metabolism* / Q000401:mortality*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood / Q000378:metabolism*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate
chemical_list: D000951:Antigens, Neoplasm; C095365:GAGE1 protein, human; C095366:GAGE2A protein, human; D009363:Neoplasm Proteins