Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy

作者：Khosrotehrani Kiarash^*; van der Ploeg Augustinus P T; Siskind Victor; Hughes Maria Celia; Wright Annaliesa; Thomas Janine; Barbour Andrew; Allan Christopher; Bayley Gerard; Eggermont Alexander; Verhoef Cornelis; Smithers B Mark; Green Adele C

来源：European Journal of Cancer, 2014, 50(7): 1301-1309.

DOI：10.1016/j.ejca.2014.02.010

• Melanoma
• Prognosis
• Metastasis lymph
• Nomogram

Background: Current staging algorithms in melanoma patients undergoing therapeutic lymph node dissection (LND) fail to accurately distinguish long-term survivors from those at risk of rapid relapse. Our goal was to establish and validate nomograms for predicting both recurrence and survival after LND.
Methods: A prospective cohort of stage IIIB and IIIC melanoma patients was ascertained from a tertiary hospital in Brisbane, Australia. Failure-time multivariate analysis identified key factors that, in adjusted combinations, generated nomograms to predict 2-year recurrence and 5-year melanoma-specific survival. The predictive value of these nomograms was further validated in a patient cohort from Rotterdam, The Netherlands.
Results: In 494 Australian patients, number of positive lymph nodes, extra-capsular extension and nodular histopathological subtype were the main independent predictors of 2-year recurrence while age, number of positive nodes and extra-capsular extension were the independent predictors of survival. Predictive value was confirmed in The Netherlands cohort of 331 patients. The nomograms were able to classify patients according to their 2-year recurrence and 5-year survival rates even within each stage III sub-class.
Conclusions: Models that include extra-capsular extension predict outcomes in patients with clinically involved lymph nodes. This tool may help tailor treatment and monitoring of this group of patients.

• 出版日期2014-5