title: Clinicopathological features, vitamin D serological levels and prognosis in cutaneous melanoma of shield-sites: an update.
abstract: Intermittent sun exposure and sunburns are strongly related to the development of melanoma (MM); however, MM can also arise in non-sun exposed areas, where other biological pathways may cause the disease, with different outcomes. At the same time, evidences of serum levels of vitamin D in melanoma patients according to sun-exposed or not-sun-exposed areas are still lacking, especially if compared with the percentage of BRAF mutation. We performed a retrospective analysis with patients registered in our electronic database and an observational study in patients with a recent diagnosis of MM. Performing Kaplan-Meier product and log-rank test, median disease-free survival was 78 months in non-shield-sites (NST-MM) patients and 20.5 months in shield-sites (ST-MM) patients (p < 0.0001); also in the long term, a better behavior was observed for NST-MM (80 vs. 42 months; p < 0.0001). Among 87 melanoma patients with a recent history of MM (≤30 days), we found that ST-MM patients showed lower values of vitamin D compared with NST-MM patients. Regarding BRAF status, a BRAF mutation was present in 13 % of ST-MM and in 41 % of NST-MM. Performing Mc-Nemar test, we found a statistical significant correlation between low serum levels of vitamin D in ST-MM and low percentage of BRAF mutation (p = 0.03), as well as between serum levels of vitamin D and high percentage of BRAF mutation in NST-MM (p < 0.001). All these aspects confirm that in ST-MM, other pathways play pivotal points, if compared with NST-MM.
authors.affiliation: Dermatologic Clinic, La Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy, gio8519@libero.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paolino
authors.forename: Elisa
authors.initials: E
authors.lastname: Moliterni
authors.forename: Dario
authors.initials: D
authors.lastname: Didona
authors.forename: Valentina
authors.initials: V
authors.lastname: Garelli
authors.forename: Paola
authors.initials: P
authors.lastname: Corsetti
authors.forename: Teresa
authors.initials: T
authors.lastname: Lopez
authors.forename: Antonio Giovanni
authors.initials: AG
authors.lastname: Richetta
authors.forename: Carmen
authors.initials: C
authors.lastname: Cantisani
authors.forename: Ugo
authors.initials: U
authors.lastname: Bottoni
authors.forename: Stefano
authors.initials: S
authors.lastname: Calvieri
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000209:etiology / Q000401:mortality; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000097:blood* / Q000209:etiology / Q000401:mortality; D013472:Sunlight / Q000009:adverse effects; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D; D048493:Proto-Oncogene Proteins B-raf