A nomogram to identify high-risk melanoma patients with a negative sentinel lymph node biopsy

Eduardo Bertolli, Mariana Petaccia de Macedo, Vinícius Fernando Calsavara, Clovis Antonio Lopes Pinto, João P. Duprat

Research output: Contribution to journalArticle

Abstract

Background: Melanoma patients with negative nodes after sentinel lymph node biopsy are a heterogeneous group. Current guidelines fail to adequately stratify surveillance and treatment for this group. Also, there is scarce data on adjuvant treatments for these patients. Objective: To create a nomogram including clinical and pathologic characteristics capable of evaluating the risk for recurrence of primary melanoma patients with negative sentinel lymph node biopsies (SLNBs). Methods: We used a retrospective cohort of patients who underwent SLNB during 2000-2015 at a single institution. Results: Our cohort comprised 1213 patients. Among these patients, 967 (79.7%) had a negative SLNB, and mean follow-up was 59.67 months. There were 133 recurrences (13.8%); 45 (33.8%) presented with nodal recurrence, and 35 (26.3%) recurred where a SLNB was performed. Breslow thickness, ulceration, and microsatellitosis were found to be predictive of risk for recurrence at 1, 2, 5, and 10 years. Limitation: Single center analysis. Conclusion: We created a predictive nomogram for melanoma patients with negative SLNBs. This nomogram is easy to use and identifies high-risk patients who should have more strict surveillance and be considered for adjuvant treatment.

Original languageEnglish (US)
JournalJournal of the American Academy of Dermatology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Sentinel Lymph Node Biopsy
Nomograms
Melanoma
Recurrence
Therapeutics
Guidelines

Keywords

  • melanoma
  • nomograms
  • recurrence
  • sentinel lymph node biopsy

ASJC Scopus subject areas

  • Dermatology

Cite this

A nomogram to identify high-risk melanoma patients with a negative sentinel lymph node biopsy. / Bertolli, Eduardo; de Macedo, Mariana Petaccia; Calsavara, Vinícius Fernando; Pinto, Clovis Antonio Lopes; Duprat, João P.

In: Journal of the American Academy of Dermatology, 01.01.2019.

Research output: Contribution to journalArticle

Bertolli, Eduardo ; de Macedo, Mariana Petaccia ; Calsavara, Vinícius Fernando ; Pinto, Clovis Antonio Lopes ; Duprat, João P. / A nomogram to identify high-risk melanoma patients with a negative sentinel lymph node biopsy. In: Journal of the American Academy of Dermatology. 2019.
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abstract = "Background: Melanoma patients with negative nodes after sentinel lymph node biopsy are a heterogeneous group. Current guidelines fail to adequately stratify surveillance and treatment for this group. Also, there is scarce data on adjuvant treatments for these patients. Objective: To create a nomogram including clinical and pathologic characteristics capable of evaluating the risk for recurrence of primary melanoma patients with negative sentinel lymph node biopsies (SLNBs). Methods: We used a retrospective cohort of patients who underwent SLNB during 2000-2015 at a single institution. Results: Our cohort comprised 1213 patients. Among these patients, 967 (79.7{\%}) had a negative SLNB, and mean follow-up was 59.67 months. There were 133 recurrences (13.8{\%}); 45 (33.8{\%}) presented with nodal recurrence, and 35 (26.3{\%}) recurred where a SLNB was performed. Breslow thickness, ulceration, and microsatellitosis were found to be predictive of risk for recurrence at 1, 2, 5, and 10 years. Limitation: Single center analysis. Conclusion: We created a predictive nomogram for melanoma patients with negative SLNBs. This nomogram is easy to use and identifies high-risk patients who should have more strict surveillance and be considered for adjuvant treatment.",
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AU - Duprat, João P.

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