Predicting recurrence in patients with sentinel node-negative melanoma: validation of the EORTC nomogram using...

Area of Science:

• Oncology
• Dermatology
• Biostatistics

Background:

• Identifying high-risk sentinel node (SN)-negative melanoma patients for recurrence is crucial.
• The European Organization for Research and Treatment of Cancer (EORTC) Melanoma Group developed a prognostic nomogram.
• External validation of the EORTC nomogram in population-based data was lacking.

Purpose of the Study:

• To externally validate the EORTC nomogram using a large national dataset.
• To assess the nomogram's predictive performance for recurrence-free survival in SN-negative melanoma patients.
• To determine the nomogram's utility in clinical practice.

Main Methods:

• Utilized data from 8795 adult patients with invasive cutaneous melanoma and negative SN biopsy in the Netherlands (2000-2014).
• Extracted relevant clinical and pathological data from the Dutch Pathology Registry.
• Assessed the EORTC nomogram's predictive performance using discrimination (C-statistic) and calibration (Hosmer-Lemeshow test).

Main Results:

• The EORTC nomogram demonstrated good predictive performance with a C-statistic of 0.70 (95% CI 0.68-0.71) for recurrence-free survival.
• The nomogram showed excellent calibration (R²=0.99; P=0.999).
• 14.7% of patients developed metastatic disease, with 20.9% of recurrences occurring after 5 years.

Conclusions:

• This population-based validation confirms the EORTC nomogram's value in predicting recurrence-free survival for SN-negative melanoma patients.
• The nomogram can aid in personalizing patient follow-up strategies.
• It assists in selecting high-risk patients for adjuvant systemic therapy clinical trials.