Early inflammatory biomarkers and melanoma survival

• Published in: International journal of dermatology 2023-06, Vol.62 (6), p.752-758
• Main Authors: Fortes, Cristina, Mastroeni, Simona, Zappalà, Albina Rita, Passarelli, Francesca, Ricci, Francesco, Abeni, Damiano, Michelozzi, Paola
• Format: Article
• Language: English
• Subjects: Biomarkers; Cohort Studies; Humans; Inflammation; Leukocytes (basophilic); Leukocytes (neutrophilic); Lymphocytes; Medical prognosis; Melanoma; Melanoma - diagnosis; Melanoma, Cutaneous Malignant; Monocytes; Multivariate analysis; Prognosis; Skin Neoplasms - diagnosis; Statistical models; Survival; Thickness
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/ijd.16629

Background Few studies have investigated the role of inflammatory markers in predicting cutaneous melanoma survival. The aim of the study was to identify, if any, early inflammatory markers in the prognosis of all stages of primary cutaneous melanoma. Methods We conducted a 10‐year cohort study among 2,141 melanoma patients from the same geographic area (Lazio) with primary cutaneous melanoma diagnosed between January 2005 and December 2013. In situ cutaneous melanoma was excluded from the analysis (N = 288), leaving 1,853 cases of invasive cutaneous melanoma. The following hematological markers were obtained from clinical records: white blood cells count (WBC), count and percentages of neutrophils, basophils, monocytes, lymphocytes, and large unstained cells (LUC). Survival probability was estimated by Kaplan–Meier methods, and prognostic factors were evaluated by multivariate analysis (Cox proportional hazards model). Results In the multivariate analysis, high levels of NLR (>2.1 vs. ≤2.1, HR: 1.61; 95% CI: 1.14–2.29, P = 0.007) and high levels of d‐NLR (>1.5 vs. ≤1.5, HR: 1.65; 95% CI: 1.16–2.35, P = 0.005) were independently associated with an increased risk of 10‐year melanoma mortality. However, when we stratified by Breslow thickness and clinical stage, we observed that NLR and d‐NLR were good markers of prognosis only for patients with Breslow thickness of 2.0 mm and more (NLR, HR: 1.62; 95% CI: 1.04–2.50; d‐NLR, HR: 1.69; 95% CI: 1.09–2.62) or clinical stage II‐IV (NLR, HR: 1.55; 95% CI: 1.01–2.37; d‐NLR, HR: 1.72; 95% CI: 1.11–2.66), independent of other prognostic factors. Conclusion We suggest that a combination of NLR and Breslow thickness may be a useful, cheap, and readily available prognostic marker for cutaneous melanoma survival.