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Prognostic factors in patients with metastatic malignant melanoma. A multivariate analysis
M N Sirott1, D F Bajorin, G Y Wong
1Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Background:
Current methods to predict survival in patients with advanced, metastatic melanoma are limited. To determine clinical prognostic factors that accurately predict survival in patients with metastatic melanoma, a retrospective analysis was performed.
Methods:
Clinical, hematologic, and biochemical pretreatment parameters from 284 patients entered on 18 Phase I and II clinical trials were analyzed to determine their prognostic effect on survival. A multivariate parametric regression based on the Weibull distribution was derived to estimate survival.
Results:
Multivariate Weibull survival regression analysis showed that a simple model using the logarithm of the pretreatment values of lactate dehydrogenase and serum albumin, dichotomized as high and low, significantly and adequately predicted survival. A more complex multivariate model was also derived that involved the pretreatment platelet count, visceral organ involvement, and gender as additional factors. However, a larger study is needed to statistically validate such a model.
Conclusions:
The pretreatment values of serum lactate dehydrogenase and albumin are independent prognostic factors for survival in patients with metastatic melanoma. These two factors can be used to estimate survival of patients with advanced, metastatic melanoma and should be considered when designing melanoma trials in which survival is an endpoint.