CT and serum LDH may predict survival rate in advanced melanoma patients

Melanoma

According to recent studies, the survival rate of patients with metastatic melanoma can now be predicted by computed tomography and serum LDH levels. Among all types of skin cancer, melanoma is the most aggressive form of skin cancer and has a very poor prognosis, especially if discovered in advanced stages.

There is a genetic predisposition for melanoma. There have been discovered several genes involved in the onset of this type of cancer, such as CDKN2A, MC1R, p53 and others. In terms of environmental factors, it is believed that sun exposure is the most important risk factor for the occurrence of melanoma. In addition, it is believed that the presence of melanocytic nevi (more than 50 nevi on the skin) and skin type (people with sensitive skin who burn easily in the sun) contributes to the development of this type of skin cancer.

Signs of malignancy of a nevus can be systematized using the well-known formula: ABCDE, which refers to asymmetry, irregular borders, changes in color, diameter greater than one inch and elevation. Other signs such as itching, bleeding or ulceration must determine the patient to consult a dermatologist.

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Researchers at the University of Mississippi Medical Center in Jackson and at the Ohio State University Comprehensive Cancer Center in Columbus, wanted to determine the survival rate in patients with metastatic melanoma treated with anti-angiogenic therapy. Therefore, clinical and laboratory data were collected (imaging investigations) in 46 patients and it seems that the results were similar to those found in patients with kidney tumors, other type of cancers that are highly vascular and also treated with anti -angiogenic therapy.

Dr. Smith said that patients with increased LDH tend to have a worse prognosis than patients with low serum LDH. He added that the level of LDH is used for staging metastatic melanoma but is weakly associated with survival rate when used alone. However, when the level of LDH and MASS Criteria findings are combined, the accuracy to predict progression-free and overall survival increases significantly.

Dr Smith said that this is an exploratory study and the next step is to verify these findings in a prospective clinical trial. The study indicates that patients with low LDH and tumor devascularization (assessed using CT) are more likely to have a favorable response to CT. Dr. Smith said they want to identify those patients who best respond to anti-angiogenic therapy to improve their quality of life and survival. Patients who do not respond to treatment should follow alternative therapies so as to avoid unnecessary drug toxicity.