Prediction of malignant melanoma recurrence by serumN‐acetylneuraminic acid

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Abstract
Since serum N‐acetylneuraminic acid (NANA) can serve as a relatively sensitive monitor of tumor burden, we wished to examine the relationship of NANA to other suggested prognostic factors for malignant melanoma. Eligible patients included 151 patients with stage‐l disease and 10 with stage‐ll regional lymphatic extension. A proportional hazards model was used to examine nine factors, of which five were not significant predictors of recurrence: age, sex, primary site, tumor diameter, and stage. Significant predictors included: measured depth p=7×10−7; anatomic depth (Clark level), p=7×10−4; NANA, p=0.003; and growth pattern (superficial spreading vs nodular), p=0.01. However, on multivariate analysis only two predictors were independent; measured depth and NANA. The latter could not be explained by non‐specific factors. The data were examined to define optimal test values for assignment of risk. According to this model, patients with lesions >l.75 mm and NANA <2μmol/ml have a more than 12‐fold greater risk of recurrence by 2 years than those with lesions ⩽1.75 mm and NANA ⩽2 μmol/ml.