PROGNOSTIC FACTORS IN PATIENTS WITH METASTATIC MALIGNANT-MELANOMA - AMULTIVARIATE-ANALYSIS

Background. Current methods to predict survival in patients with advan ced, metastatic melanoma are limited. To determine clinical prognostic factors that accurately predict survival in patients with metastatic melanoma, a retrospective analysis was performed. Methods. Clinical, h ematologic, and biochemical pretreatment parameters from 284 patients entered on 18 Phase I and II clinical trials were analyzed to determin e their prognostic effect on survival. A multivariate parametric regre ssion based on the Weibull distribution was derived to estimate surviv al. Results. Multivariate Weibull survival regression analysis showed that a simple model using the logarithm of the pretreatment values of lactate dehydrogenase and serum albumin, dichotomized as high and low, significantly and adequately predicted survival. A more complex multi variate model was also derived that involved the pretreatment platelet count, visceral organ involvement, and gender as additional factors. However, a larger study is needed to statistically validate such a mod el. Conclusions. The pretreatment values of serum lactate dehydrogenas e and albumin are independent prognostic factors for survival in patie nts with metastatic melanoma. These two factors can be used to estimat e survival of patients with advanced, metastatic melanoma and should b e considered when designing melanoma trials in which survival is an en dpoint.