S-100B in the follow-up of patients with stage III and IV melanoma: pursuit of the Holy Grail


  • L. L. G. C. Ackermans Department of Surgery, Zuyderland Medical Center, Sittard, The Netherlands
  • L. Aldenhoven Department of Surgery, Zuyderland Medical Center, Sittard, The Netherlands
  • J. W. A. M. Bosmans Department of Surgery, Zuyderland Medical Center, Sittard, The Netherlands
  • S. M. J. Van Kuijk Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, the Netherlands
  • J. Van Bastelaar Department of Surgery, Zuyderland Medical Center, Sittard, The Netherlands




Melanoma, S-100B marker, Follow-up, Recurrent disease



Background: Patients with stage III-IV melanoma are at considerable risk for disease recurrence. Early detection of recurrence is important to optimize immunotherapy administration and improving progression-free and overall survival. S-100B can be used as tumor marker to evaluate whether patients are at risk for developing disease recurrence or progression. It could be a promising tool to determine whether patients need to receive additional diagnostic procedures. However, implementation in routine clinical setting is limited. Hence, this study aimed to evaluate the value of S-100B as a decision tool for the need to perform an 18F-fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET/CT) to confirm disease recurrence or progression in stage III-IV melanoma patients.

Methods: Data of 51 stage III-IV melanoma patients, presenting for follow-up after surgery with curative intent, was retrospectively extracted from a single-center electronic patient record system. 18FDG-PET/CT was performed based on clinical signs or elevated S-100B levels. S-100B measurements were treated as independent data points.

Results: Fifteen out of 303 S-100B levels were elevated. Six elevated levels were causes by disease progression; 4/6 measurements were noted with concurrent clinical signs. Twenty-four events of disease progression were confirmed. The sensitivity and specificity of S-100B serum test were 25.0% [95% CI (9.8-46.7)] and 96.8% [95% CI (94.0-98.5)]. The positive predictive value (PPV) and negative predictive value (NPV) of S-100B were 40.0% [95% CI (20.6-63.2)] and 93.8% [95% CI (92.2-95.0)].

Conclusions: Elevated S-100B levels did not exclude nor indicate metastatic or recurrent disease in this study. Using S-100B in routine clinical setting does not seem to be of additional value.

Author Biography

L. L. G. C. Ackermans, Department of Surgery, Zuyderland Medical Center, Sittard, The Netherlands

Resident, Surgery Department


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Original Research Articles