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

Publication date: Available online 2 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Eduardo Bertolli, Mariana Petaccia de Macedo, Vinícius Fernando Calsavara, Clovis Antonio Lopes Pinto, João Pedreira Duprat Neto

Summary

Background

Melanoma patients with negative nodes following sentinel 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.

Objectives

To create a nomogram based on clinical and pathological characteristics of primary melanoma to evaluate the risk of recurrence in patients with negative SNB.

Methods

Retrospective cohort of patients who underwent SNB from 2000 to 2015 in a single institution.

Results

Our cohort comprised 1,213 patients. Among these patients, 967 (79.7%) had a negative SNB 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 SNB was performed. Breslow thickness, ulceration, and microsatellitosis were found to be predictive of risk of recurrence at one, two, five, and ten years.

Limitations

single center analysis.

Conclusions

we created a predictive nomogram for melanoma patients after a negative SNB. It is easy to use and identifies high-risk patients who should have more strict surveillance and consideration of adjuvant treatment.

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