PROGNOSTIC IMPLICATIONS OF DNA INDEX IN PATIENTS WITH STAGE-III CUTANEOUS MELANOMA

DNA flow cytometry of the lymph node metastases from 56 patients was u sed to retrospectively evaluate the prognostic significance of DNA plo idy in patients with stage III melanoma. The findings were correlated with traditional prognostic factors and patient survival. Multivariate regression analysis revealed that, in addition to the number of posit ive lymph nodes and patient gender, the DNA index was a significant pr edictor of patient survival (all p <0.03). Within this cohort of patie nts, the patients with the poorest prognoses were those with DNA indic es greater than 2 (at least tetraploid), more than three positive lymp h nodes, and male gender. There was a significant survival difference among the patients having zero, one, or two of these risk factors (p < 0.001). Our results indicate that DNA analysis of melanoma metastases by flow cytometry provides an additional discriminating factor for pre dicting patient outcome after therapeutic lymph node dissection. This information may be useful in directing patients with stage III melanom a at higher risk for recurrence into clinical trials of more aggressiv e systemic adjuvant therapy.