title: Clinical outcome and pathological features associated with NRAS mutation in cutaneous melanoma.
abstract: The effect of NRAS mutations on the pathological features and clinical outcomes in patients with cutaneous melanoma was compared with that of tumors containing BRAF(V600E) mutations and tumors wild type for both (WT). Clinical outcome data were obtained from a prospective cohort of 249 patients. Mutations involving NRAS and BRAF(V600E) were detected by PCR and were sequence verified. Cox proportional hazards regression was performed to relate NRAS and BRAF mutations to clinical outcome. Seventy-five percentage of NRAS mutations occurred in tumors >1 mm thick (BRAF(V600E) 40%, WT 34%); 75% of NRAS mutations had >1 mitosis/mm(2) (BRAF(V600E) 40%, WT 55%). When compared to WT, multivariate analysis of melanoma-specific survival (MSS) identified NRAS mutations as an adverse prognostic factor [hazard ratio (HR) 2.96; P = 0.04] but not BRAF(V600E) mutations (HR 1.73; P = 0.23). NRAS mutations were associated with thicker tumors and higher rates of mitosis when compared to BRAF(V600E) and WT melanoma and independently of this, with shorter MSS.
authors: Division of Cancer Medicine and Research, Peter MacCallum Cancer Centre, East Melbourne, Vic., Australia.
authors: Bianca
authors: B
authors: Devitt
authors: Wendy
authors: W
authors: Liu
authors: Renato
authors: R
authors: Salemi
authors: Rory
authors: R
authors: Wolfe
authors: John
authors: J
authors: Kelly
authors: Chin-Yuan
authors: CY
authors: Tzen
authors: Alexander
authors: A
authors: Dobrovic
authors: Grant
authors: G
authors: McArthur