NEW YORK (Reuters Health) Apr 08 - Higher serum amyloid A (SAA) levels in patients with melanoma are associated with worse progression-free and overall survival, according to a report in the March 23rd online issue of the Journal of Clinical Oncology.
Currently recognized serum biomarkers of melanoma are powerful predictors of outcome in metastatic disease, but weak in early-stage patients, the authors explain.
Dr. Peter Findeisen from University of Heidelberg in Germany and colleagues investigated the prognostic value of SAA in comparison to S100B, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in patients comprising all clinical stages of melanoma.
Patients with SAA levels below 10 mg/L showed a favorable survival compared with patients with higher SAA levels, the authors report.
S100B, SAA and CRP were all independent prognostic factors.
SAA was a significant prognostic marker among patients in stage I-III and in patients in stage IV.
Among patients in earlier stages (I-III), only SAA and CRP proved to be significant prognostic markers.
The combination of SAA and CRP proved significantly better than SAA or CRP alone in predicting outcomes, the researchers note.
"The significant interaction found between CRP and SAA by multivariate analysis deserves particular notification, as far as we observed a significant decrease in the probability of survival starting from patients showing normal values of both markers, followed by patients showing elevated levels of SAA, then followed by patients showing elevated levels of CRP, and finally ending with the worst prognosis in patients showing elevated levels of both SAA and CRP," the investigators report.
"These results indicate that SAA and CRP combined could serve as useful prognostic serum biomarkers in melanoma, particularly in early-stage patients," the authors conclude. "In this patient group these new markers could help to identify patients at high risk of disease progression in strong need of adjuvant treatment."
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