Annals of Surgical Oncology

, Volume 19, Issue 13, pp 4314–4321

Prognostic Value of BRAFV600 Mutations in Melanoma Patients After Resection of Metastatic Lymph Nodes

  • Stéphanie Moreau
  • Philippe Saiag
  • Philippe Aegerter
  • Daphné Bosset
  • Christine Longvert
  • Zofia Hélias-Rodzewicz
  • Cristi Marin
  • Frédérique Peschaud
  • Sophie Chagnon
  • Utte Zimmermann
  • Thierry Clerici
  • Jean-François Emile
Melanomas

DOI: 10.1245/s10434-012-2457-5

Cite this article as:
Moreau, S., Saiag, P., Aegerter, P. et al. Ann Surg Oncol (2012) 19: 4314. doi:10.1245/s10434-012-2457-5

Abstract

Purpose

BRAFV600 mutations are frequent in melanomas, and BRAFV600-targeted therapy have dramatic, but often transitory, efficacy in stage IV patients. Prognosis of patients with American Joint Committee on Cancer (AJCC) stage III melanoma is heterogeneous. We aimed to determine the overall survival (OS) of stage III patients with a nodal deposit of ≥2 mm according to BRAFV600 mutations and other previously reported prognostic criteria.

Methods

This retrospective study included 105 consecutive patients with stage III cutaneous melanomas. Most patients underwent a prospective follow-up. BRAFV600 mutations were detected by sequencing and pyrosequencing of DNA in samples containing >60 % melanoma cells.

Results

BRAF mutations (p.V600E and p.V600K in 83 and 14 % of cases, respectively) were detected in 40 % of the patients. For patients with and without BRAF mutations, death occurred in 83.3 and 60.3 %, with a median OS of 1.4 and 2.8 years, respectively. Patient age, primary melanoma ulceration, number of invaded lymph nodes, AJCC staging at study entry, and BRAF status were linked to OS in the univariate analysis. The only characteristics associated with OS in the multivariate analysis were number of invaded lymph nodes (P = 0.005, hazard ratio 2.2, 95 % confidence interval 1.3–3.9) and BRAF status (P = 0.005, hazard ratio 1.9, 95 % confidence interval 1.2–3.1).

Conclusions

BRAFV600 status could be used to stage melanoma patients with nodal deposits. Our results may also help to plan adjuvant trials in these patients, for whom the low tumor load may induce longer efficacy of BRAF-targeted therapies.

Supplementary material

10434_2012_2457_MOESM1_ESM.pdf (110 kb)
Supplementary material 1 (PDF 110 kb)

Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Stéphanie Moreau
    • 1
    • 2
  • Philippe Saiag
    • 3
    • 4
  • Philippe Aegerter
    • 5
    • 6
  • Daphné Bosset
    • 1
    • 3
  • Christine Longvert
    • 3
    • 4
  • Zofia Hélias-Rodzewicz
    • 1
    • 2
  • Cristi Marin
    • 1
    • 2
  • Frédérique Peschaud
    • 4
    • 7
  • Sophie Chagnon
    • 8
  • Utte Zimmermann
    • 1
    • 4
  • Thierry Clerici
    • 1
    • 4
  • Jean-François Emile
    • 1
    • 2
  1. 1.Department of PathologyAmbroise Paré HospitalBoulogneFrance
  2. 2.EA4340Versailles SQY UniversityBoulogneFrance
  3. 3.Department of General and Oncologic DermatologyAmbroise Paré HospitalBoulogneFrance
  4. 4.EA4339Versailles SQY UniversityBoulogneFrance
  5. 5.Public Health DepartmentAmbroise Paré HospitalBoulogneFrance
  6. 6.EA2506Versailles SQY UniversityBoulogneFrance
  7. 7.Department of SurgeryAmbroise Paré HospitalBoulogneFrance
  8. 8.Department of Radiology, AP-HPAmbroise Paré HospitalBoulogneFrance

Personalised recommendations