Importantly, patients with metastasis naïve for treatment derived from primary cutaneous melanoma showed a significant correlation between high C/N CSDE1 ratios and worse progression free survival (PFS), increasing the risk of PFS by 6.6 times (means of 1.8 years for low vs 0.3 years for high C/N) (Figure 4G). This evidence concerns the gene CSDE1 and cutaneous melanoma.