VASCULARITY AND PROGNOSIS OF METASTATIC MELANOMA

The clinical role of vascularity was examined in metastatic melanoma, analyzing the correlation of the blood vessel density and prognosis. O ur study included 51 specimens of metastatic melanoma tissue samples f rom 31 patients treated with combined chemo-immunotherapy, PECAM-1 (CD 31) was used for assessing vascularity by immunohistochemical staining . On the basis of blood vessel counts, patients were classified into 2 main groups: low and high vascularity. A higher blood vessel density was found to be associated with shorter survival, estimated from the p rimary diagnosis of the disease (38 months), compared with patients wi th low blood vessel counts (68 months). A similar tendency was observe d when vascularity was correlated to the survival period after the det ection of the first metastases (13 vs. 30 months) and with survival si nce the initiation of chemo-immunotherapy (8 vs, 16 months). When vasc ularity and some common prognostic factors, such as age, sex, DNA ploi dy and WHO tumor response, were used for a Cox multivariate analysis, vascularity turned out to he the most significant independent prognost ic factor. Our results suggest that counting the blood vessels identif ied by immunohistochemical staining for the endothelial cell-specific CD31 is a powerful predictor for prognosis in patients with metastatic melanoma and should be considered when selecting patients for therapy . (C) 1997 Wiley-Liss, Inc.