Clinical characteristics of malignant melanoma in central China and predictors of metastasis

Abstract

Cutaneous malignant melanoma (MM) is the most malignant type of all skin neoplasms. There is wide variability in the characteristics of MM between patients of different races. The aim of the present study was to investigate the clinicopathological characteristics of patients with MM in central China and to assess the value of specific hematological and biochemical indices for predicting metastasis. The data of 167 patients with MM from the First Affiliated Hospital of Zhengzhou University (Henan, China) were retrospectively analyzed and compared with the data of patients with MM available from cBioPortal for Cancer Genomics. Following analysis of the clinicopathological characteristics of the 167 patients, the median overall survival time was 50 months, and the median disease-free survival time was 35 months. Albumin/D-dimer prognosis score (ADPS), lactate dehydrogenase, sex, T stage, tumor-node-metastasis stage, Breslow thickness, Clark level, histological type, growth phase, ulceration and metastasis were all significantly associated with prognosis. An ADPS of <341.01 was identified as an independent predictor of metastasis. The trial registration no. is 2018-LW-037 and this clinical trial was registered in the First Affiliated Hospital of Zhengzhou University Clinical Trial Registry in March 1, 2018.

Keywords: MM; albumin/D-dimer; cBioPortal; metastasis; prognosis.

Figure 1.

Comparison of clinical characteristics between the cBioPortal cohort and the experimental cohort. (A) Categorization of patients in cBioPortal by race. (Ba) Categorization of patients in cBioPortal by age. (Bb) Categorization of patients in the experimental cohort by age at diagnosis. (Ca) OS from cBioPortal. (Cb) OS of experimental cohort. (Da) DFS from cBioPortal. (Db) DFS from the experimental cohort. (Ea) Overall survival status from cBioPortal cohort. (Eb) OS from the experimental cohort. (Fa) Sex of patients from the cBioPortal cohort. (Fb) Sex of patients from the experimental cohort. (Ga) Anatomic regions of MM for patients with MM of the cBioPortal cohort. (Gb) Anatomic regions of MM for patients with MM of the experimental cohort. OS, overall survival; DFS, disease free survival; MM, malignant melanoma.

Figure 2.

Venn diagram of treatments of patients with MM received in the experimental cohort. MM, malignant melanoma.

Figure 3.

ROC curve of patients with MM in the experimental cohort. ROC, Receiver operating characteristic; MM, malignant melanoma; ADPS, serum albumin/D-dimer prognosis score; PDPS, serum prealbumin/D-dimer prognosis score.

Figure 4.

Kaplan-Meier analyses of 10-year OS for the entire cohort of patients according to different stratums by prognostic factors. OS of patients based on (A) sex (P<0.01), (B) T stage (compared with T0, T1, T2, T3 and T4; P<0.001), (C) TNM stage (compared with TNM stage I/II, III and IV; P<0.001), (D) Breslow thickness (compared with Breslow I, II, III and IV; P<0.001), (E) Clark level (compared with Clark level 1, 2, 3, 4 and 5; P<0.001), (F) histological type (compared with ALM, NM, SSM, LMM, MCM and unclassifiable; P<0.001), (G) growth phase (P<0.001), (H) anatomic region (compared with trunk, head/neck, extremities, mucosal and unknown; P>0.05), (I) ulceration (P<0.001), (J) metastasis (P<0.001), (K) albumin/D-dimer (P<0.01), (L) LDH levels (P<0.01). OS, overall survival; T, Tumor; TNM, tumor node metastasis; LDH, lactate dehydrogenase; ALM, acral lentiginous melanoma; NM, nodular melanoma; SSM, superficial spreading melanoma; MCM, mucosal melanoma.