Prognostic classification of malignant melanomas by combining clinical, histological, and immunohistochemical parameters

In a retrospective study the prognostic relevance of clinical, histopatholo gical, immunohistochemical, and flowcytometric parameters in primary malign ant melanomas was evaluated using both the receiver operating characteristi c ROC procedure and the logistic regression model. The proteolytic enzymes collagenase IV, cathepsin B, and cathepsin D proved to be significant progn ostic factors. Combining the results obtained with these enzymes with gende r, anatomic site, tumour thickness, Clark's level, ulceration, pattern of i nvasive growth, and presence of large round cells resulted in greatly impro ved discrimination between metastasized and non-metastasized cases. It is a nticipated that this method could allow for precise individual prognostic c haracterization and in particular for identification of high-risk patients for adjuvant therapy.