Validation of a Nomogram to Predict the Presence of Sentinel Lymph Node Metastases in Melanoma

Piñero, Antonio; Canteras, Manuel; Ortiz, Eduardo J.; Martínez‐Barba, Enrique; Parrilla, Pascual

doi:10.1245/s10434-008-0077-x

Cited by 22 publications

(18 citation statements)

References 22 publications

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“…Several nomograms have been established for melanoma in recent years. Clinical and pathological features were applied to construct a nomogram to predict sentinel lymph node metastases in melanoma ( 45 , 46 ). Nomograms were also developed to identify the risk, recurrence, and mortality in patients with negative sentinel lymph nodes ( 47 , 48 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Implications of Metabolism Related Gene Signature in Cutaneous Melanoma

Zeng

Peng

et al. 2020

Front. Oncol.

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Metabolic reprogramming is closely related to melanoma. However, the prognostic role of metabolism-related genes (MRGs) remains to be elucidated. We aimed to establish a nomogram by combining MRGs signature and clinicopathological factors to predict melanoma prognosis. Eighteen prognostic MRGs between melanoma and normal samples were identified using The Cancer Genome Atlas (TCGA) and GSE15605. WARS (HR = 0.881, 95% CI = 0.788-0.984, P = 0.025) and MGST1 (HR = 1.124, 95% CI = 1.007-1.255, P = 0.037) were ultimately identified as independent prognostic MRGs with LASSO regression and multivariate Cox regression. The MRGs signature was established according to these two genes and externally validated in the Gene Expression Omnibus (GEO) dataset. Kaplan-Meier survival analysis indicated that patients in the high-risk group had significantly poorer overall survival (OS) than those in the low-risk group. Furthermore, the MRGs signature was identified as an independent prognostic factor for melanoma survival. An MRGs nomogram based on the MRGs signature and clinicopathological factors was developed in TCGA cohort and validated in the GEO dataset. Calibration plots showed good consistency between the prediction of nomogram and actual observation. The receiver operating characteristic curve and decision curve analysis indicated that MRGs nomogram had better OS prediction and clinical net benefit than the stage system. To our knowledge, we are the first to develop a prognostic nomogram based on MRGs signature with better predictive power than the current staging system, which could assist individualized prognosis prediction and improve treatment.

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Section: Discussionmentioning

confidence: 99%

Prognostic Implications of Metabolism Related Gene Signature in Cutaneous Melanoma

Zeng

Peng

et al. 2020

Front. Oncol.

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“…Several clinico-pathological characteristics have been inconsistently associated with SNB positivity in a number of studies, including Clark's level, ulceration, mitotic count, microsatellites, vessel invasion, TILs, tumour site and age (Mraz-Gernhard et al , 1998; Porter et al , 2000; Wagner et al , 2000; McMasters et al , 2001; Nguyen et al , 2001; Rousseau et al , 2003; Sondak et al , 2004; Kesmodel et al , 2005; Wong et al , 2005; Kruper et al , 2006; Paek et al , 2007; Taylor et al , 2007; Pinero et al , 2008; Sartore et al , 2008). Although some previous studies have showed that patients in younger age groups were more likely to have a positive sentinel node (McMasters et al , 2001; Rousseau et al , 2003; Sondak et al , 2004; Paek et al , 2007), we found no association between age and SNB status in our study when analysing age as either a continous or categorical variable (<50 or >50 years).…”

Section: Discussionmentioning

confidence: 99%

Melanoma sentinel node biopsy and prediction models for relapse and overall survival

et al. 2010

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Background:To optimise predictive models for sentinal node biopsy (SNB) positivity, relapse and survival, using clinico-pathological characteristics and osteopontin gene expression in primary melanomas.Methods:A comparison of the clinico-pathological characteristics of SNB positive and negative cases was carried out in 561 melanoma patients. In 199 patients, gene expression in formalin-fixed primary tumours was studied using Illumina's DASL assay. A cross validation approach was used to test prognostic predictive models and receiver operating characteristic curves were produced.Results:Independent predictors of SNB positivity were Breslow thickness, mitotic count and tumour site. Osteopontin expression best predicted SNB positivity (P=2.4 × 10−7), remaining significant in multivariable analysis. Osteopontin expression, combined with thickness, mitotic count and site, gave the best area under the curve (AUC) to predict SNB positivity (72.6%). Independent predictors of relapse-free survival were SNB status, thickness, site, ulceration and vessel invasion, whereas only SNB status and thickness predicted overall survival. Using clinico-pathological features (thickness, mitotic count, ulceration, vessel invasion, site, age and sex) gave a better AUC to predict relapse (71.0%) and survival (70.0%) than SNB status alone (57.0, 55.0%). In patients with gene expression data, the SNB status combined with the clinico-pathological features produced the best prediction of relapse (72.7%) and survival (69.0%), which was not increased further with osteopontin expression (72.7, 68.0%).Conclusion:Use of these models should be tested in other data sets in order to improve predictive and prognostic data for patients.

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“…The incidence of melanoma has risen faster than any other cancer worldwide [1,2] and the status of the sentinel lymph node (SLN) is the single most important prognostic factor [3]. Whilst there are several algorithms for predicting metastases of melanoma to the SLN [4][5][6][7][8][9][10] their external validity is weak [4,[11][12][13][14]. Consequently, only 1 in 5 patients undergoing SLN biopsy yield a node with microscopic deposits [15].…”

Section: Introductionmentioning

confidence: 99%

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

Robinson

Keeble

et al. 2020

Cancer Immunol Immunother

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Objectives The neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker which is useful in cancer prognostication. We aimed to investigate the differences in baseline NLR between patients with localised and metastatic cutaneous melanoma and how this biomarker changed over time with the recurrence of disease. Methods This multicentre cohort study describes patients treated for Stage I-III cutaneous melanoma over 10 years. The baseline NLR was measured immediately prior to surgery and again at the time of discharge or disease recurrence. The odds ratios (OR) for sentinel node involvement are estimated using mixed-effects logistic regression. The risk of recurrence is estimated using multivariable Cox regression. Results Overall 1489 individuals were included. The mean baseline NLR was higher in patients with palpable nodal disease compared to those with microscopic nodal or localised disease (2.8 versus 2.4 and 2.3, respectively; p < 0.001). A baseline NLR ≥ 2.3 was associated with 30% higher odds of microscopic metastatic melanoma in the sentinel lymph node [adjusted OR 1.3 (95% CI 1.3, 1.3)]. Following surgery, 253 patients (18.7%) developed recurrent melanoma during surveillance although there was no statistically significant association between the baseline NLR and the risk of recurrence [adjusted HR 0.9 (0.7, 1.1)]. Conclusion The NLR is associated with the volume of melanoma at presentation and may predict occult sentinel lymph metastases. Further prospective work is required to investigate how NLR may be modelled against other clinicopathological variables to predict outcomes and to understand the temporal changes in NLR following surgery for melanoma.

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Validation of a Nomogram to Predict the Presence of Sentinel Lymph Node Metastases in Melanoma

Abstract: The nomogram is a useful diagnostic tool that provides an adequate accurate prediction of the probability of sentinel lymph node metastases in patients with cutaneous melanoma.

Cited by 22 publications

References 22 publications

Prognostic Implications of Metabolism Related Gene Signature in Cutaneous Melanoma

Prognostic Implications of Metabolism Related Gene Signature in Cutaneous Melanoma

Melanoma sentinel node biopsy and prediction models for relapse and overall survival

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

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