Prospective multi-institutional study of reverse transcriptase polymerase chain reaction for molecular staging of melanoma

Charles R. Scoggins, Merrick I. Ross, Douglas S. Reintgen, R. Dirk Noyes, James S. Goydos, Peter D. Beitsch, Marshall M. Urist, Stephan Ariyan, B. Scott Davidson, Jeffrey J. Sussman, Michael J. Edwards, Robert C.G. Martin, Angela M. Lewis, Arnold J. Stromberg, Andrew J. Conrad, Lee Hagendoorn, Jeffrey Albrecht, Kelly M. McMasters

Research output: Contribution to journalArticlepeer-review

108 Scopus citations

Abstract

Purpose: To evaluate the prognostic significance of molecular staging using reverse transcriptase polymerase chain reaction (RT-PCR) in detecting occult melanoma cells in sentinel lymph nodes (SLNs) and circulating bloodstream. Patients and Methods: In this multicenter study, eligibility criteria included patient age 18 to 71 years, invasive melanoma ≥ 1.0 mm Breslow thickness, and no clinical evidence of metastasis. SLN biopsy and wide excision of the primary tumor were performed. SLNs were examined by serial-section histopathology and S-100 immunohistochemistry. A portion of each SLN was frozen for RT-PCR. In addition, RT-PCR was performed on peripheral-blood mononuclear cells (PBMCs). RT-PCR analysis was performed using four markers: tyrosinase, MART1, MAGE3, and GP-100. Disease-free survival (DFS), distant-DFS (DDFS), and overall survival (OS) were analyzed. Results: A total of 1,446 patients with histologically negative SLNs underwent RT-PCR analysis. At a median follow-up of 30 months, there was no difference in DFS, DDFS, or OS between the RT-PCR-positive (n = 620) and RT-PCR-negative (n = 826) patients. Analysis of PBMC from 820 patients revealed significant differences in DFS and DDFS, but not OS, for patients with detection of more than one RT-PCR marker in peripheral blood. Conclusion: In this large, prospective, multi-institutional study, RT-PCR analysis on SLNs and PBMCs provides no additional prognostic information beyond standard histopathologic analysis of SLNs. Detection of more than one marker in PBMC is associated with a worse prognosis. RT-PCR remains investigational and should not be used to direct adjuvant therapy at this time.

Original languageEnglish (US)
Pages (from-to)2849-2857
Number of pages9
JournalJournal of Clinical Oncology
Volume24
Issue number18
DOIs
StatePublished - Jun 20 2006

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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