Carlo Riccardo Rossi1,2, Simone Mocellin3,4, Luca Giovanni Campana1,2, Lorenzo Borgognoni5, Serena Sestini5, Giuseppe Giudice6, Corrado Caracò7, Adriana Cordova8, Nicola Solari9, Dario Piazzalunga10, Paolo Carcoforo11, Pietro Quaglino12, Virginia Caliendo13, Simone Ribero12,13. 1. Surgical Oncology Unit, IOV-IRCCS of Padova, Padua, Italy. 2. Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padua, Italy. 3. Surgical Oncology Unit, IOV-IRCCS of Padova, Padua, Italy. simone.mocellin@unipd.it. 4. Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padua, Italy. simone.mocellin@unipd.it. 5. Centro di Riferimento Regionale per il Melanoma, Ospedale S.M. Annunziata, Azienda USL Toscana Centro, Florence, Italy. 6. U.O.C. di Chirurgia Plastica Ricostruttiva e Centro Ustioni Policlinico, University of Bari, Bari, Italy. 7. Struttura Complessa Chirurgia Oncologica Melanoma - Istituto Nazionale Tumori Pascale, Napoles, Italy. 8. A.O.U.P. Paolo Giaccone, Dip. Discipline Chirurgiche, University of Palermo, Oncologiche e Stomatologiche - Sezione di Chirurgia Plastica, Palermo, Italy. 9. Chirurgia I - Ospedale San Martino, Genoa, Italy. 10. Chirurgia Generale 1, Ospedale Papa Giovanni XXIII, Bergamo, Italy. 11. UOC Chirurgia II Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. 12. Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy. 13. Dermatologic Surgery Division, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Abstract
BACKGROUND AND PURPOSE: Approximately 20% of melanoma patients harbor metastases in non-sentinel nodes (NSNs) after a positive sentinel node biopsy (SNB), and recent evidence questions the therapeutic benefit of completion lymph node dissection (CLND). We built a nomogram for prediction of NSN status in melanoma patients with positive SNB. METHODS: Data on anthropometric and clinicopathological features of patients with cutaneous melanoma who underwent CLND after a positive SNB were collected from nine Italian centers. Multivariate logistic regression was utilized to identify predictors of NSN status in a training set, while model efficiency was validated in a validation set. RESULTS: Data were available for 1220 patients treated from 2000 through 2016. In the training set (n = 810), the risk of NSN involvement was higher when (1) the primary melanoma is thicker or (2) sited in the trunk/head and neck; (3) fewer nodes are excised and (4) more nodes are involved; and (5) the lymph node metastasis is larger or (6) is deeply located. The model showed high discrimination (area under the receiver operating characteristic curve 0.74, 95% confidence interval [CI] 0.70-0.79) and calibration (Brier score 0.16, 95% CI 0.15-0.17) performance in the validation set (n = 410). The nomogram including these six clinicopathological variables performed significantly better than five other previously published models in terms of both discrimination and calibration. CONCLUSIONS: Our nomogram could be useful for follow-up personalization in clinical practice, and for patient risk stratification while conducting clinical trials or analyzing their results.
BACKGROUND AND PURPOSE: Approximately 20% of melanomapatients harbor metastases in non-sentinel nodes (NSNs) after a positive sentinel node biopsy (SNB), and recent evidence questions the therapeutic benefit of completion lymph node dissection (CLND). We built a nomogram for prediction of NSN status in melanomapatients with positive SNB. METHODS: Data on anthropometric and clinicopathological features of patients with cutaneous melanoma who underwent CLND after a positive SNB were collected from nine Italian centers. Multivariate logistic regression was utilized to identify predictors of NSN status in a training set, while model efficiency was validated in a validation set. RESULTS: Data were available for 1220 patients treated from 2000 through 2016. In the training set (n = 810), the risk of NSN involvement was higher when (1) the primary melanoma is thicker or (2) sited in the trunk/head and neck; (3) fewer nodes are excised and (4) more nodes are involved; and (5) the lymph node metastasis is larger or (6) is deeply located. The model showed high discrimination (area under the receiver operating characteristic curve 0.74, 95% confidence interval [CI] 0.70-0.79) and calibration (Brier score 0.16, 95% CI 0.15-0.17) performance in the validation set (n = 410). The nomogram including these six clinicopathological variables performed significantly better than five other previously published models in terms of both discrimination and calibration. CONCLUSIONS: Our nomogram could be useful for follow-up personalization in clinical practice, and for patient risk stratification while conducting clinical trials or analyzing their results.
Authors: Jane Yuet Ching Hui; Erin Burke; Kristy K Broman; Schelomo Marmor; Eric Jensen; Todd M Tuttle; Jonathan S Zager Journal: J Surg Oncol Date: 2020-12-01 Impact factor: 3.454
Authors: Kristy K Broman; Tasha M Hughes; Lesly A Dossett; James Sun; Michael J Carr; Dennis A Kirichenko; Avinash Sharma; Edmund K Bartlett; Amanda Ag Nijhuis; John F Thompson; Tina J Hieken; Lisa Kottschade; Jennifer Downs; David E Gyorki; Emma Stahlie; Alexander van Akkooi; David W Ollila; Jill Frank; Yun Song; Giorgos Karakousis; Marc Moncrieff; Jenny Nobes; John Vetto; Dale Han; Jeffrey Farma; Jeremiah L Deneve; Martin D Fleming; Matthew Perez; Kirsten Baecher; Michael Lowe; Roger Olofsson Bagge; Jan Mattsson; Ann Y Lee; Russell S Berman; Harvey Chai; Hidde M Kroon; Roland M Teras; Juri Teras; Norma E Farrow; Georgia M Beasley; Jane Yc Hui; Lukas Been; Schelto Kruijff; David Boulware; Amod A Sarnaik; Vernon K Sondak; Jonathan S Zager Journal: J Am Coll Surg Date: 2020-12-13 Impact factor: 6.532
Authors: Paolo Antonio Ascierto; Lorenzo Borgognoni; Gerardo Botti; Michele Guida; Paolo Marchetti; Simone Mocellin; Paolo Muto; Giuseppe Palmieri; Roberto Patuzzo; Pietro Quaglino; Ignazio Stanganelli; Corrado Caracò Journal: J Transl Med Date: 2019-08-14 Impact factor: 5.531