A prospective analysis of c-myc oncoprotein levels as a prognostic marker in malignant melanoma.

Abstract

Previous studies from our group had identified c-myc oncoprotein expression as an important prognostic parameter in a series of retrospective studies of primary and metastatic melanoma and other variants of this disease. This study set out to prospectively evaluate the prognostic significance of c-myc positivity in a consecutive series of primary melanomas presenting at Mount Vernon Hospital Regional Plastic Surgery and Burns Centre. A consecutive series of 117 primary melanomas underwent flow cytometric analysis for c-myc expression at diagnosis. Routine clinical and histological parameters were collected from each patient's clinical records and survival assessed. The mean follow up was 45 months. Kaplan-Meier survival analysis demonstrated that Breslow depth, histogenic subtype, ulceration, age and sex had prognostic significance. Survival analysis revealed high c-myc positivity to be significantly associated with poorer outcome (P<0.043). Each of the main prognostic parameters were assessed for their independent significance using Cox Proportional Hazards; only c-myc retained independent significance (P<0.039). The strength of this study is that it was performed in a consecutive series of patients followed up in a longitudinal prospective study. c-myc was not the strongest predictor of survival in univariate analysis, but was the only parameter that retained significance in multivariate analysis.