The role of microsatellites as a prognostic factor in primary malignant melanoma.
OBJECTIVE
To determine the impact of microsatellites as a prognostic factor in primary cutaneous melanoma.


METHODS
Retrospective cohort study.


METHODS
Tertiary referral center. Patients A total of 504 patients with a history of primary melanoma observed for 2 years or having experienced a first relapse.


METHODS
Overall survival (OS) and relapse-free survival (RFS).


RESULTS
Forty-five patients had evidence of microsatellites in their primary melanoma. Presence of microsatellites significantly correlated with the presence of several other histologic high-risk factors such as tumor thickness, ulceration, Clark level, vascular factors, and mitotic rate. Univariate analysis demonstrated decreased RFS and OS in patients with microsatellites. Presence of microsatellites was associated with increased locoregional metastasis but not distant metastasis. In multivariate analysis, with the inclusion of 6 other clinical and histologic factors, presence of microsatellites was a significant predictor of RFS but not OS. Patients with clinical macrosatellites had a trend toward worsening OS compared with those with microsatellites.


CONCLUSIONS
The presence of microsatellites is intimately tied to other markers of melanoma aggressiveness. Microsatellites appear to predict locoregional relapse and RFS but neither distant metastasis nor OS. These results may have implications for patient care as well as the inclusion of microsatellites in stage III of the current classification.
Shaikh
Ladan
L
Melanoma Center, Cutaneous Oncology Program, Cancer Center, University of California, San Francisco, CA 94115, USA.
Sagebiel
Richard W
RW
Ferreira
Carlos M M
CM
Nosrati
Mehdi
M
Miller
James R
JR
Kashani-Sabet
Mohammed
M
D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018895:Microsatellite Repeats; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis
D014408:Biomarkers, Tumor