Prospective multi-institutional study of reverse transcriptase polymerase chain reaction for molecular staging of melanoma.

Scoggins, Charles R; Ross, Merrick I; Reintgen, Douglas S; Noyes, R Dirk; Goydos, James S; Beitsch, Peter D; Urist, Marshall M; Ariyan, Stephan; Davidson, B Scott; Sussman, Jeffrey J; Edwards, Michael J; Martin, Robert C G; Lewis, Angela M; Stromberg, Arnold J; Conrad, Andrew J; Hagendoorn, Lee; Albrecht, Jeffrey; McMasters, Kelly M

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Updated in 8/12/2020 12:04:40 PM

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(Journal Article)

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 24 (18): 2849-57 (2006)

Prospective multi-institutional study of reverse transcriptase polymerase chain reaction for molecular staging of melanoma.

Charles R Scoggins , Merrick I Ross , Douglas S Reintgen , R Dirk Noyes , James S Goydos , Peter D Beitsch , Marshall M Urist , Stephan Ariyan , B Scott Davidson , Jeffrey J Sussman , Michael J Edwards , Robert C G Martin , Angela M Lewis , Arnold J Stromberg , Andrew J Conrad , Lee Hagendoorn , Jeffrey Albrecht , Kelly M McMasters

ABSTRACT
To evaluate the prognostic significance of molecular staging using reverse transcriptase polymerase chain reaction (RT-PCR) in detecting occult melanoma cells in sentinel lymph nodes (SLNs) and circulating bloodstream.In this multicenter study, eligibility criteria included patient age 18 to 71 years, invasive melanoma > or = 1.0 mm Breslow thickness, and no clinical evidence of metastasis. SLN biopsy and wide excision of the primary tumor were performed. SLNs were examined by serial-section histopathology and S-100 immunohistochemistry. A portion of each SLN was frozen for RT-PCR. In addition, RT-PCR was performed on peripheral-blood mononuclear cells (PBMCs). RT-PCR analysis was performed using four markers: tyrosinase, MART1, MAGE3, and GP-100. Disease-free survival (DFS), distant-DFS (DDFS), and overall survival (OS) were analyzed.A total of 1,446 patients with histologically negative SLNs underwent RT-PCR analysis. At a median follow-up of 30 months, there was no difference in DFS, DDFS, or OS between the RT-PCR-positive (n = 620) and RT-PCR-negative (n = 826) patients. Analysis of PBMC from 820 patients revealed significant differences in DFS and DDFS, but not OS, for patients with detection of more than one RT-PCR marker in peripheral blood.In this large, prospective, multi-institutional study, RT-PCR analysis on SLNs and PBMCs provides no additional prognostic information beyond standard histopathologic analysis of SLNs. Detection of more than one marker in PBMC is associated with a worse prognosis. RT-PCR remains investigational and should not be used to direct adjuvant therapy at this time.

DOI: 10.1200/JCO.2005.03.2342

ISSN: 0732-183X

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Position:	Professor
About me:	James Goydos, MD is widely recognized as an expert in melanoma research & surgical oncology. In his over 20 years of experience as a surgeon, he has conducted research that has translated into patient care, clinical trials, & cutting-edge treatment. His research and clinical trials have recorded growth arrest in melanoma cells, transforming the area of cancer genomics. Goydos has decades of experience as a Professor of Surgery and researcher at UMDNJ Robert Wood Johnson Medical School. He is an advocate for patient privacy and is recognized for leadership in patient care by the Cancer Institute of New Jersey and MRF. By 2020, his work in melanoma & innovative trials have led him to record numerous awards by Castle Connolly. He has helped individuals to better understand the mechanics of melanoma, the invasion of the dermis, and to see that it is not always a death sentence.
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