Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy
| Autor: | Annaliesa Wright, Andrew Barbour, Janine Thomas, Maria Celia B. Hughes, Christopher Paul Allan, Augustinus P. T. van der Ploeg, B. Mark Smithers, Victor Siskind, Cornelis Verhoef, Gerard Bayley, Kiarash Khosrotehrani, Adèle C. Green, Alexander M.M. Eggermont |
|---|---|
| Přispěvatelé: | Surgery |
| Rok vydání: | 2014 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Multivariate analysis Skin Neoplasms Metastasis Decision Support Techniques Predictive Value of Tests Internal medicine medicine Humans Prospective Studies Prospective cohort study Lymph node Melanoma Aged Netherlands business.industry Nomogram Middle Aged medicine.disease Survival Analysis Surgery Dissection Nomograms medicine.anatomical_structure Cohort Lymph Node Excision Female Queensland Neoplasm Recurrence Local business |
| Zdroj: | European Journal of Cancer, 50(7), 1301-1309. Elsevier Ltd. |
| ISSN: | 0959-8049 |
| DOI: | 10.1016/j.ejca.2014.02.010 |
| Popis: | Background: Current staging algorithms in melanoma patients undergoing therapeutic lymph node dissection (LND) fail to accurately distinguish long-term survivors from those at risk of rapid relapse. Our goal was to establish and validate nomograms for predicting both recurrence and survival after LND. Methods: A prospective cohort of stage IIIB and IIIC melanoma patients was ascertained from a tertiary hospital in Brisbane, Australia. Failure-time multivariate analysis identified key factors that, in adjusted combinations, generated nomograms to predict 2-year recurrence and 5-year melanoma-specific survival. The predictive value of these nomograms was further validated in a patient cohort from Rotterdam, The Netherlands. Results: In 494 Australian patients, number of positive lymph nodes, extra-capsular extension and nodular histopathological subtype were the main independent predictors of 2-year recurrence while age, number of positive nodes and extra-capsular extension were the independent predictors of survival. Predictive value was confirmed in The Netherlands cohort of 331 patients. The nomograms were able to classify patients according to their 2-year recurrence and 5-year survival rates even within each stage III sub-class. Conclusions: Models that include extra-capsular extension predict outcomes in patients with clinically involved lymph nodes. This tool may help tailor treatment and monitoring of this group of patients. (C) 2014 Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect