title: A prospective analysis of c-myc oncoprotein levels as a prognostic marker in malignant melanoma.
abstract: BACKGROUND
  Previous studies from our group had identified c-myc oncoprotein expression as an important prognostic parameter in a series of retrospective studies of primary and metastatic melanoma and other variants of this disease. This study set out to prospectively evaluate the prognostic significance of c-myc positivity in a consecutive series of primary melanomas presenting at Mount Vernon Hospital Regional Plastic Surgery and Burns Centre.
  
  
  METHODS
  A consecutive series of 117 primary melanomas underwent flow cytometric analysis for c-myc expression at diagnosis. Routine clinical and histological parameters were collected from each patient's clinical records and survival assessed. The mean follow up was 45 months.
  
  
  RESULTS
  Kaplan-Meier survival analysis demonstrated that Breslow depth, histogenic subtype, ulceration, age and sex had prognostic significance. Survival analysis revealed high c-myc positivity to be significantly associated with poorer outcome (P<0.043). Each of the main prognostic parameters were assessed for their independent significance using Cox Proportional Hazards; only c-myc retained independent significance (P<0.039).
  
  
  CONCLUSIONS
  The strength of this study is that it was performed in a consecutive series of patients followed up in a longitudinal prospective study. c-myc was not the strongest predictor of survival in univariate analysis, but was the only parameter that retained significance in multivariate analysis.
authors.affiliation: RAFT Institute of Plastic Surgery, Mount Vernon Hospital, Northwood, London, UK. alex.ramsden@nuth.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Ramsden
authors.forename: R
authors.initials: R
authors.lastname: Grover
authors.forename: J
authors.initials: J
authors.lastname: Chana
authors.forename: P
authors.initials: P
authors.lastname: Tulley
authors.forename: R
authors.initials: R
authors.lastname: Sanders
authors.forename: G D
authors.initials: GD
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D016271:Proto-Oncogene Proteins c-myc / Q000032:analysis*; D012878:Skin Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D016271:Proto-Oncogene Proteins c-myc