Development and validation of a nomogram to predict recurrence and melanoma‐specific mortality in patients with negative sentinel lymph nodes.
Published: 11th October 2018
Authors: D. Verver, D. van Klaveren, V. Franke, A. C. J. van Akkooi, P. Rutkowski, U. Keilholz et al.
Patients with melanoma and negative sentinel nodes (SNs) have varying outcomes, dependent on several prognostic factors. Considering all these factors in a prediction model might aid in identifying patients who could benefit from a personalized treatment strategy. The objective was to construct and validate a nomogram for recurrence and melanoma‐specific mortality (MSM) in patients with melanoma and negative SNs.
A total of 3220 patients with negative SNs were identified from a cohort of 4124 patients from four EORTC Melanoma Group centres who underwent sentinel lymph node biopsy. Prognostic factors for recurrence and MSM were studied with Cox regression analysis. Significant factors were incorporated in the models. Performance was assessed by discrimination (c‐index) and calibration in cross‐validation across the four centres. A nomogram was developed for graphical presentation.
There were 3180 eligible patients. The final prediction model for recurrence and the calibrated model for MSM included three independent prognostic factors: ulceration, anatomical location and Breslow thickness. The c‐index was 0·74 for recurrence and 0·76 for the calibrated MSM model. Cross‐validation across the four centres showed reasonable model performance. A nomogram was developed based on these models. One‐third of the patients had a 5‐year recurrence probability of 8·2 per cent or less, and one‐third had a recurrence probability of 23·0 per cent or more.
A nomogram for predicting recurrence and MSM in patients with melanoma and negative SNs was constructed and validated. It could provide personalized estimates useful for tailoring surveillance strategies (reduce or increase intensity), and selection of patients for adjuvant therapy or clinical trials.Full text
You may also be interested in
Meta‐analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes.
Authors: M. Roman, A. Monaghan, G. F. Serraino, D. Miller, S. Pathak, F. Lai et al.
Notes: Possible but how much is enough?
Multicentre cohort study of antihypertensive and lipid‐lowering therapy cessation after bariatric surgery.
Authors: J. Thereaux, T. Lesuffleur, S. Czernichow, A. Basdevant, S. Msika, D. Nocca et al.
Notes: Better than controls
Authors: M. S. de Vos, J. F. Hamming
Authors: A. M. Warwick, T. Jenks, R. Fisher, R. Garrett‐Cox, F. Lecky, D. Yates et al.
Notes: Better in hospitals with a paediatric surgeon
Experimental study of needle recording electrodes placed on the thyroid cartilage for neuromonitoring during thyroid surgery.
Authors: Y. Zhao, C. Li, D. Zhang, L. Zhou, X. Liu, S. Li et al.
Notes: Quick and stable
Authors: D. J. Harris, S. J. Vine, M. R. Wilson, J. S. McGrath, M.‐E. LeBel, G. Buckingham et al.
Notes: Watching other surgeons helpful
Authors: A. Storesund, A. S. Haugen, M. Hjortås, M. W. Nortvedt, H. Flaatten, G. E. Eide et al.
Notes: Code correctly
Authors: O. Uleberg, K. Pape, T. Kristiansen, P. R. Romundstad, P. Klepstad
Authors: G. Polychronidis, F. J. Hüttner, P. Contin, K. Goossen, L. Uhlmann, M. Heidmann et al.
Authors: F. F. A. IJpma, T. M. van Gulik