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Is BRAF a prognostic factor in stage III skin melanoma? A retrospective study of 72 patients after positive sentinel
M Picard1, N Pham Dang, M D'Incan
1Maxillo Facial Surgery Department, University Hospital, Clermont-Ferrand, Auvergne, France.
Background:
BRAF was identified as an oncogene in skin melanoma in 2002, and since 2011 has been a therapeutic target in the treatment of metastatic melanoma. The role of BRAF mutation in tumour initiation and the disease course remains to be elucidated.
Objectives:
The main objective of our study was to determine whether there is a relationship between BRAF status and overall survival in patients with a melanoma and a positive sentinel lymph node. We also sought an association between BRAF status and the clinicopathological features of the melanoma. Finally, we looked for a potential heterogeneity of BRAF status in primary and metastatic tumours.
Methods:
All patients (n = 72) treated for melanoma and with a positive sentinel lymph node at the University Hospital of Clermont-Ferrand, France, between January 2000 and January 2010 were enrolled in the study. We investigated BRAF status in primary melanoma and lymph node metastatic tissue in our molecular pathology laboratory and collected the clinical and survival data.
Results:
Of the 72 patients, 32 had at least one BRAF mutation. There was a statistically significant difference in overall survival between the BRAF-mutated and wild-type populations. The only clinical feature related to BRAF status was metastatic burden. Of the 25 patients in whom we obtained the status in both locations, five had a discordant result.
Conclusions:
BRAF mutation is an indicator of poor prognosis in patients with stage III melanoma with a positive sentinel lymph node. BRAF status could be used in the staging of this population. BRAF has a role not only in cellular immortalization but also in metastatic spread.
Insights
BRAF mutations are linked to poorer survival in melanoma patients with positive sentinel lymph nodes. This finding suggests BRAF status can aid in staging and understanding melanoma progression.
Area of Science:
- Oncology
- Molecular Pathology
- Genetics
Background:
- BRAF oncogene identified in skin melanoma (2002).
- BRAF is a therapeutic target for metastatic melanoma since 2011.
- Role of BRAF mutation in melanoma initiation and progression requires further elucidation.
Purpose of the Study:
- Determine the relationship between BRAF status and overall survival in melanoma patients with positive sentinel lymph nodes.
- Investigate associations between BRAF status and melanoma clinicopathological features.
- Assess potential heterogeneity of BRAF status in primary versus metastatic tumors.
Main Methods:
- Retrospective study of 72 melanoma patients with positive sentinel lymph nodes (2000-2010).
- BRAF mutation status analyzed in primary melanoma and lymph node metastatic tissue.
- Collection of clinical and survival data.
Main Results:
- 32 out of 72 patients (44%) harbored BRAF mutations.
- Statistically significant difference in overall survival observed between BRAF-mutated and wild-type groups.
- Metastatic burden was the only clinicopathological feature associated with BRAF status. Five of 25 patients showed discordant BRAF status between primary and metastatic sites.
Conclusions:
- BRAF mutation indicates a poor prognosis for stage III melanoma patients with positive sentinel lymph nodes.
- BRAF status may be valuable for staging melanoma patients.
- BRAF plays a role in both cellular immortalization and metastatic spread.
