Serum S100B, lactate dehydrogenase and brain metastasis are prognostic factors in patients with distant melanoma metastasis and systemic therapy

PLoS One. 2013 Nov 28;8(11):e81624. doi: 10.1371/journal.pone.0081624. eCollection 2013.

Abstract

Background: Prognostic factors of melanoma with distant metastasis and systemic treatment are only poorly established. This study aimed to analyse the impact of S100B, lactate dehydrogenase (LDH) and the type of treatment on survival in advanced patients receiving systemic treatment.

Patients and methods: We analysed overall survival of 499 patients from the university department of dermatology in Tuebingen, Germany, with unresectable melanoma at the time point of initiation of first-line systemic therapy. Only patients who started treatment between the years 2000 and 2010 were included. Disease-specific survival was calculated by bivariate Kaplan Meier survival probabilities and multivariate Cox hazard regression analysis.

Results: In univariate analysis LDH, S100B, the site of distant metastasis (soft tissue vs. lung vs. other visceral), the presence of brain metastases and the type of treatment (monochemotherapy, polychemotherapy, immunotherapy or biochemotherapy) were associated with overall survival (all p<0.001). In multivariate analysis LDH (Hazard ratio [HR] 1.6 [1.3-2.1]; p<0.001), S100B (HR 1.6 [1.2-2.1]; p<0.001) and the presence of brain metastases (HR 1.5 [1.1-1.9]; p = 0.009), but not the type of treatment had significant independent impact. Among those factors normal S100B was the best indicator of long-term survival, which was 12.3% after 5 years for this subgroup.

Conclusion: Serum S100B is a prognostic marker predicting survival at the time of initiation of first-line treatment in unresectable melanoma patients. Compared to the other independent factors LDH and the presence of brain metastases it is most appropriate to predict long-term survival and requires further prospective investigation in patients treated with new and more potent drugs in metastatic melanoma.

MeSH terms

  • Aged
  • Brain Neoplasms / secondary*
  • Female
  • Humans
  • L-Lactate Dehydrogenase / blood*
  • Male
  • Melanoma / blood
  • Melanoma / diagnosis*
  • Melanoma / pathology*
  • Melanoma / therapy
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • S100 Proteins / blood*
  • Skin Neoplasms / blood
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy

Substances

  • S100 Proteins
  • L-Lactate Dehydrogenase

Grant support

The authors have no support or funding to report.