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NF-B in the Vascular Progression of Melanoma

From the Auerback Melanoma Research Laboratory and Melanoma Center, Cutaneous Oncology Program, Cancer Center, University of California San Francisco; and California Pacific Medical Research Institute, San Francisco, San Francisco, CA

Address reprint requests to Mohammed Kashani-Sabet, MD, University of California San Francisco Cancer Center, 1600 Divisadero St, 2nd Floor, San Francisco, CA 94115; e-mail: kashanim{at}derm.ucsf.edu

PURPOSE: To examine a model of melanoma progression based on vascular factors and the role of NF-B in the vascular progression of melanoma.

PATIENTS AND METHODS: A data set of 526 patients from the University of California San Francisco Melanoma Center with 2 years of follow-up or first relapse was studied. The impact of the presence or absence of various prognostic factors on overall survival of melanoma patients was assessed using Cox regression and Kaplan-Meier analysis. A matched-pair analysis of NF-B expression was performed in cases with vascular involvement and increased tumor vascularity versus matched controls lacking these factors.

RESULTS: Cox regression analysis of factors evaluated by the American Joint Committee on Cancer Melanoma Staging Committee reproduced the powerful impact of tumor thickness and ulceration in this data set. With the inclusion of vascular factors such as tumor vascularity and vascular involvement, ulceration was no longer significant in predicting overall survival. By multivariate analysis, vascular involvement and tumor vascularity were the strongest predictors of melanoma outcome. Tumor vascularity seems to be a precursor of both vascular involvement and ulceration. A matched-pair tissue array analysis demonstrated the significant correlation between overexpression of NF-B–p65 and the development of vascular factors.

CONCLUSION: Vascular factors play an important role in the progression of malignant melanoma. Ulceration may be a surrogate marker for the interactions between melanoma and the tumor vasculature. NF-B seems to play an important role in the development of these factors.

Supported by an educational grant from the Skin Disease Research Foundation (San Francisco, CA) and the Mark Shafir Fund.

Presented in part at the 39th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, May 31-June 3, 2003.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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