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

M. A. El Sharouni, T. Ahmed, A. J. Witkamp, V. Sigurdsson, C. H. van Gils, O. E. Nieweg, R. A. Scolyer, J. F. Thompson, P. J. van Diest, S. N. Lo

Research output: Contribution to journalArticle

Abstract

Background: Identifying patients with sentinel node (SN)-negative melanoma who are at greatest risk of recurrence is important. The European Organization for Research and Treatment of Cancer (EORTC) Melanoma Group proposed a prognostic model that has not been validated in population-based data. The EORTC nomogram includes Breslow thickness, ulceration status and anatomical location as parameters. The aim of this study was to validate the EORTC model externally using a large national data set. Methods: Adults with histologically proven, invasive cutaneous melanoma with a negative SN biopsy in the Netherlands between 2000 and 2014 were identified from the Dutch Pathology Registry, and relevant data were extracted. The EORTC nomogram was used to predict recurrence-free survival. The predictive performance of the nomogram was assessed by discrimination (C-statistic) and calibration. Results: A total of 8795 patients met the eligibility criteria, of whom 14·7 per cent subsequently developed metastatic disease. Of these recurrences, 20·9 per cent occurred after the first 5 years of follow-up. Validation of the EORTC nomogram showed a C-statistic of 0·70 (95 per cent c.i. 0·68 to 0·71) for recurrence-free survival, with excellent calibration (R2 = 0·99; P = 0·999, Hosmer–Lemeshow test). Conclusion: This population-based validation confirmed the value of the EORTC nomogram in predicting recurrence-free survival in patients with SN-negative melanoma. The EORTC nomogram could be used in clinical practice for personalizing follow-up and selecting high-risk patients for trials of adjuvant systemic therapy.

Original languageEnglish
JournalBritish Journal of Surgery
DOIs
Publication statusE-pub ahead of print - 26 Aug 2020
Externally publishedYes

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