MelRisk: Using neutrophil-to-lymphocyte ratio to improve risk prediction models for metastatic cutaneous melanoma in the sentinel lymph node.

Autor: Wade RG; Faculty of Medicine and Health, Worsley Building, University of Leeds, Leeds, UK; Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds, UK. Electronic address: ryckiewade@gmail.com., Bailey S; Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds, UK., Robinson AV; Faculty of Medicine and Health, Worsley Building, University of Leeds, Leeds, UK., Lo MCI; Norwich Medical School, University of East Anglia, Norwich, UK., Peach H; Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds, UK., Moncrieff MDS; Department of Plastic & Reconstructive Surgery, Norfolk & Norwich University Hospital NHS Trust, Norwich, UK; Norwich Medical School, University of East Anglia, Norwich, UK., Martin J; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2022 May; Vol. 75 (5), pp. 1653-1660. Date of Electronic Publication: 2021 Dec 01.
DOI: 10.1016/j.bjps.2021.11.088
Abstrakt: Background: Identifying metastatic melanoma in the sentinel lymph node (SLN) is important because 80% of SLN biopsies are negative and 11% of patients develop complications. The neutrophil-to-lymphocyte ratio (NLR), a biomarker of micrometastatic disease, could improve prediction models for SLN status. We externally validated existing models and developed 'MelRisk' prognostic score to better predict SLN metastasis.
Methods: The models were externally validated using data from a multicenter cohort study of 1,251 adults. Additionally, we developed and internally validated a new prognostic score `MelRisk', using candidate predictors derived from the extant literature.
Results: The Karakousis model had a C-statistic of 0.58 (95% CI, 0.54-0.62). The Sondak model had a C-statistic of 0.57 (95% CI 0.53-0.61). The MIA model had a C-statistic of 0.60 (95% CI. 0.56-0.64). Our 'MelRisk' model (which used Breslow thickness, ulceration, age, anatomical site, and the NLR) showed an adjusted C-statistic of 0.63 (95% CI, 0.56-0.64).
Conclusion: Our prediction tool is freely available in the Google Play Store and Apple App Store, and we invite colleagues to externally validate its performance .
(Copyright © 2021 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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