BAUSSS biomarker improves melanoma survival risk assessment

Anthony J Dixon; Howard K Steinman; Alexander Nirenberg; Christos C Zouboulis; Michael Sladden; Catalin Popescu; Stuart Anderson; Caterina Longo; J Meirion Thomas

doi:10.1111/jdv.20292

BAUSSS biomarker improves melanoma survival risk assessment

J Eur Acad Dermatol Venereol. 2024 Aug 31. doi: 10.1111/jdv.20292. Online ahead of print.

Authors

Anthony J Dixon^{1

2}, Howard K Steinman³, Alexander Nirenberg¹, Christos C Zouboulis⁴, Michael Sladden⁵, Catalin Popescu⁶, Stuart Anderson^{1

7}, Caterina Longo^{8

9}, J Meirion Thomas¹⁰

Affiliations

¹ Australasian College of Cutaneous Oncology, Docklands, Victoria, Australia.
² American Osteopathic College of Dermatology, Kirksville, Missouri, USA.
³ Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA.
⁴ Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany.
⁵ University of Tasmania, Launceston, Tasmania, Australia.
⁶ Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁷ Maffra Medical Group, Maffra, Victoria, Australia.
⁸ Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
⁹ Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy.
¹⁰ Formerly of Royal Marsden Hospital, Chelsea, UK.

PMID: 39215563
DOI: 10.1111/jdv.20292

Abstract

Background: The American Joint Committee on Cancer (AJCC) method of staging melanoma is dated and inaccurate. It ignores important prognostic melanoma features, especially the patient's age. BAUSSS is more accurate in determining survival risk for primary cutaneous melanoma patients who have no clinical or imaging evidence of nodal or distant metastases. BAUSSS is an algorithm incorporating analysis of Breslow thickness, Age, Ulceration, Subtype of melanoma, Sex and Site. These are the six features from the patient history along with the details from the melanoma pathology report that are most predictive of mortality outcome.

Objective: To develop a single-page document that allows the clinician to determine BAUSSS biomarker-predicted prognosis in consultation with the patient.

Method: From various data sources, we developed an algorithm to predict melanoma mortality using the BAUSSS biomarker system. The single-page algorithm was made available to download at https://globalmelanoma.net/bausss-survival-chart, thus being readily available without charge to all clinicians and their patients.

Results: BAUSSS method of determining melanoma prognosis is more accurate and less costly than the AJCC staging system. The only surgery the patient requires is wide local excision of the primary tumour. This method of ascertaining melanoma risk does not require added surgery, costs, hospitalization, tests and anaesthesia, such as would be required if sentinel lymph node biopsy was undertaken. BAUSSS can be a useful tool in determining which primary melanoma patients are at sufficiently high risk to be considered for adjuvant drug therapy.

Conclusion: We encourage clinicians to download and print in colour this single-page BAUSSS mortality prediction tool, laminate it, and use it face to face with the patient in consultations. Not only will the patient be able to recognize his/her long-term prognosis but will also be able to see how their tumour severity compares with others.