title: Revisiting determinants of prognosis in cutaneous melanoma.
abstract: The American Joint Committee on Cancer staging system for cutaneous melanoma is based on primary tumor thickness and the presence of ulceration, mitoses, lymph node spread, and distant metastases as determinants of prognosis. Although this cutaneous melanoma staging system has evolved over time to more accurately reflect patient prognosis, improvements are still needed, because current understanding of the particular factors (genetic mutation, expression alteration, host response, etc) that are critical for predicting patient outcomes is incomplete. Given the clinical and biologic heterogeneity of primary melanomas, new prognostic tools are needed to more precisely identify patients who are most likely to develop advanced disease. Such tools would affect clinical surveillance strategies and aid in patient selection for adjuvant therapy. The authors reviewed the literature on prognostic molecular and immunologic markers in primary cutaneous melanoma, their associations with clinicopathologic and survival outcomes, and their potential for incorporation into current staging models. Overall, the studies considered in this review did not define prognostic markers that could be readily incorporated into the current staging system. Therefore, efforts should be continued in these and other directions to maximize the likelihood of identifying clinically useful prognostic biomarkers for cutaneous melanoma.
authors: Department of Medical Oncology, New York University School of Medicine, New York, New York.|Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, New York.
authors: Sarah A
authors: SA
authors: Weiss
authors: Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, New York.|Department of Pathology, New York University School of Medicine, New York, New York.
authors: Douglas
authors: D
authors: Hanniford
authors: Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, New York.|Department of Pathology, New York University School of Medicine, New York, New York.
authors: Eva
authors: E
authors: Hernando
authors: Department of Medical Oncology, New York University School of Medicine, New York, New York.|Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, New York.|Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
authors: Iman
authors: I
authors: Osman
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D008545:Melanoma / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012878:Skin Neoplasms / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor
keywords: biomarkers; genetics; melanoma; messenger RNA; microRNAs; prognostic; staging; tumor-infiltrating lymphocytes