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We performed prospective serial studies on 266 melanoma patients undergoing surgery for high risk primary or lymph node metastases to assess the predictive value for recurrence of melanoma of S-100beta detection in the serum using immunoradiometric assay (IRMA) or Immunoluminometric assay (LIA-mat). The tests for S-100beta were most frequently positive in the first 3 months after surgery. Results of the assays did not show a strong correlation with clinical stage of the disease. Studies on a cohort of 147 patients who had been followed for a minimum of 2 years post-surgery were carried out to assess the sensitivity of the assays for identifying patients who develop recurrence of their melanoma. The LIA-mat and IRMA assays detected S-100beta in the serum of 47.5% and 23%, respectively, of the subset of 61 patients who developed recurrence of disease. By Kaplan Meler analysis, patients positive for S-100beta by LIA-mat assay in the first 3 months post-surgery were shown to have an approximately 2.7 times shorter disease-free survival (DFS) period than patients negative for S-100beta. This was significant by log rank analysis. Multivariate analysis indicated that the presence of S-100beta was an independent prognostic determinant of DFS, and was independent of tumour thickness and lymph node status. This prospective analysis in a large number of patients suggests that assays for S-100beta in patients following surgical resection of AJCC stage I-III melanoma are of limited value for identifying patients who will develop recurrence of their disease. The results of the LIA-mat assays, but not the IRMA assays, do however provide an additional measure of prognosis that is independent of existing measures.
Curry et al. (Wed,) studied this question.