BRAF mutation status is an independent prognostic factor for resected stage IIIB and IIIC melanoma: Implications for melanoma staging and adjuvant therapy
Copyright policy )BRAF mutation status is an independent prognostic factor for resected stage IIIB and IIIC melanoma: Implications for melanoma staging and adjuvant therapy
5-year survival for melanoma metastasis to regional lymph nodes (American Joint Committee on Cancer stage III) is 3cm or extracapsular invasion. Mutations were detected using an extended Sequenom MelaCARTA panel.Mutations were most commonly detected in BRAF (57/124 [46%] patients) and NRAS (26/124 [21%] patients). Patients with BRAF mutations had higher 3-year recurrence rate (77%) versus 54% for BRAF wild-type patients (hazard ratio (HR) 1.8, p=0.008). The only prognostically significant mutations occurred in BRAF: median recurrence-free (RFS) and disease-specific survival (DSS) for BRAF mutation patients was 7 months and 16 months, versus 19 months and not reached for BRAF wild-type patients, respectively. Multivariate analysis identified BRAF mutant status and number of positive lymph nodes as the only independent prognostic factors for RFS and DSS.Patients with BRAF mutations experienced rapid progression of metastatic disease with locoregional recurrence rarely seen in isolation, supporting incorporation of BRAF status into melanoma staging and use of BRAF/MEK inhibitors post-TLND.
- University of Queensland Australia
- University of Queensland Australia
- Princess Alexandra Hospital Australia
- Translational Research Institute Australia
- University of Queensland Australia
Male, Proto-Oncogene Proteins B-raf, DNA Mutational Analysis, Kaplan-Meier Estimate, Proto-Oncogene Mas, Outcome Assessment, Health Care, Humans, 1306 Cancer Research, Melanoma, Neoplasm Staging, Proportional Hazards Models, Oncogenes, Middle Aged, Prognosis, Proto-oncogene proteins B-raf, Lymphatic Metastasis, Multivariate Analysis, Mutation, Lymph Node Excision, 2730 Oncology, Female, Immunotherapy, Neoplasm Recurrence, Local, Molecular diagnostic techniques, Follow-Up Studies
Male, Proto-Oncogene Proteins B-raf, DNA Mutational Analysis, Kaplan-Meier Estimate, Proto-Oncogene Mas, Outcome Assessment, Health Care, Humans, 1306 Cancer Research, Melanoma, Neoplasm Staging, Proportional Hazards Models, Oncogenes, Middle Aged, Prognosis, Proto-oncogene proteins B-raf, Lymphatic Metastasis, Multivariate Analysis, Mutation, Lymph Node Excision, 2730 Oncology, Female, Immunotherapy, Neoplasm Recurrence, Local, Molecular diagnostic techniques, Follow-Up Studies
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