Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy
Identifieur interne : 004044 ( Main/Exploration ); précédent : 004043; suivant : 004045Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy
Auteurs : Kiarash Khosrotehrani [Australie] ; Augustinus P. T. Van Der Ploeg [Pays-Bas] ; Victor Siskind [Australie] ; Maria Celia Hughes [Australie] ; Annaliesa Wright [Australie] ; Janine Thomas [Australie] ; Andrew Barbour [Australie] ; Christopher Allan [Australie] ; Gerard Bayley [Australie] ; Alexander Eggermont [Pays-Bas, France] ; Cornelis Verhoef [Pays-Bas] ; B. Mark Smithers [Australie] ; Adele C. Green [Australie, Royaume-Uni]Source :
- European journal of cancer : (1990) [ 0959-8049 ] ; 2014.
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Abstract
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.
Affiliations:
- Australie, France, Pays-Bas, Royaume-Uni
- Angleterre, Grand Manchester, Hollande-Méridionale
- Manchester, Rotterdam
- Université de Manchester
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy</title><author><name sortKey="Khosrotehrani, Kiarash" sort="Khosrotehrani, Kiarash" uniqKey="Khosrotehrani K" first="Kiarash" last="Khosrotehrani">Kiarash Khosrotehrani</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group</s1><s2>Brisbane, QLD</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane, QLD</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>The University of Queensland, UQ Diamantina Institute, Translational Research Institute</s1><s2>Woolloongabha, QLD</s2><s3>AUS</s3><sZ>1 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabha, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Ploeg, Augustinus P T" sort="Van Der Ploeg, Augustinus P T" uniqKey="Van Der Ploeg A" first="Augustinus P. T." last="Van Der Ploeg">Augustinus P. T. Van Der Ploeg</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Erasmus MC Cancer Institute</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Siskind, Victor" sort="Siskind, Victor" uniqKey="Siskind V" first="Victor" last="Siskind">Victor Siskind</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group</s1><s2>Brisbane</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Hughes, Maria Celia" sort="Hughes, Maria Celia" uniqKey="Hughes M" first="Maria Celia" last="Hughes">Maria Celia Hughes</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group</s1><s2>Brisbane</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Wright, Annaliesa" sort="Wright, Annaliesa" uniqKey="Wright A" first="Annaliesa" last="Wright">Annaliesa Wright</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group</s1><s2>Brisbane, QLD</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Thomas, Janine" sort="Thomas, Janine" uniqKey="Thomas J" first="Janine" last="Thomas">Janine Thomas</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Barbour, Andrew" sort="Barbour, Andrew" uniqKey="Barbour A" first="Andrew" last="Barbour">Andrew Barbour</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Allan, Christopher" sort="Allan, Christopher" uniqKey="Allan C" first="Christopher" last="Allan">Christopher Allan</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Bayley, Gerard" sort="Bayley, Gerard" uniqKey="Bayley G" first="Gerard" last="Bayley">Gerard Bayley</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Eggermont, Alexander" sort="Eggermont, Alexander" uniqKey="Eggermont A" first="Alexander" last="Eggermont">Alexander Eggermont</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Erasmus MC Cancer Institute</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Institut de Cancérologie Gustave Roussy</s1><s2>Villejuif-Paris</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif-Paris</wicri:noRegion><wicri:noRegion>Institut de Cancérologie Gustave Roussy</wicri:noRegion><wicri:noRegion>Institut de Cancérologie Gustave Roussy</wicri:noRegion></affiliation></author><author><name sortKey="Verhoef, Cornelis" sort="Verhoef, Cornelis" uniqKey="Verhoef C" first="Cornelis" last="Verhoef">Cornelis Verhoef</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Erasmus MC Cancer Institute</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Smithers, B Mark" sort="Smithers, B Mark" uniqKey="Smithers B" first="B. Mark" last="Smithers">B. Mark Smithers</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Green, Adele C" sort="Green, Adele C" uniqKey="Green A" first="Adele C." last="Green">Adele C. Green</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group</s1><s2>Brisbane</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Sciences Centre</s1><s2>Manchester</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region><settlement type="city">Manchester</settlement></placeName><orgName type="university">Université de Manchester</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">14-0098383</idno><date when="2014">2014</date><idno type="stanalyst">PASCAL 14-0098383 INIST</idno><idno type="RBID">Pascal:14-0098383</idno><idno type="wicri:Area/PascalFrancis/Corpus">000490</idno><idno type="wicri:Area/PascalFrancis/Curation">005971</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000180</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000180</idno><idno type="wicri:doubleKey">0959-8049:2014:Khosrotehrani K:nomograms:to:predict</idno><idno type="wicri:Area/Main/Merge">004104</idno><idno type="wicri:Area/Main/Curation">004044</idno><idno type="wicri:Area/Main/Exploration">004044</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy</title><author><name sortKey="Khosrotehrani, Kiarash" sort="Khosrotehrani, Kiarash" uniqKey="Khosrotehrani K" first="Kiarash" last="Khosrotehrani">Kiarash Khosrotehrani</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group</s1><s2>Brisbane, QLD</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane, QLD</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>The University of Queensland, UQ Diamantina Institute, Translational Research Institute</s1><s2>Woolloongabha, QLD</s2><s3>AUS</s3><sZ>1 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabha, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Ploeg, Augustinus P T" sort="Van Der Ploeg, Augustinus P T" uniqKey="Van Der Ploeg A" first="Augustinus P. T." last="Van Der Ploeg">Augustinus P. T. Van Der Ploeg</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Erasmus MC Cancer Institute</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Siskind, Victor" sort="Siskind, Victor" uniqKey="Siskind V" first="Victor" last="Siskind">Victor Siskind</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group</s1><s2>Brisbane</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Hughes, Maria Celia" sort="Hughes, Maria Celia" uniqKey="Hughes M" first="Maria Celia" last="Hughes">Maria Celia Hughes</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group</s1><s2>Brisbane</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Wright, Annaliesa" sort="Wright, Annaliesa" uniqKey="Wright A" first="Annaliesa" last="Wright">Annaliesa Wright</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group</s1><s2>Brisbane, QLD</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Thomas, Janine" sort="Thomas, Janine" uniqKey="Thomas J" first="Janine" last="Thomas">Janine Thomas</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Barbour, Andrew" sort="Barbour, Andrew" uniqKey="Barbour A" first="Andrew" last="Barbour">Andrew Barbour</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Allan, Christopher" sort="Allan, Christopher" uniqKey="Allan C" first="Christopher" last="Allan">Christopher Allan</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Bayley, Gerard" sort="Bayley, Gerard" uniqKey="Bayley G" first="Gerard" last="Bayley">Gerard Bayley</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Eggermont, Alexander" sort="Eggermont, Alexander" uniqKey="Eggermont A" first="Alexander" last="Eggermont">Alexander Eggermont</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Erasmus MC Cancer Institute</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Institut de Cancérologie Gustave Roussy</s1><s2>Villejuif-Paris</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif-Paris</wicri:noRegion><wicri:noRegion>Institut de Cancérologie Gustave Roussy</wicri:noRegion><wicri:noRegion>Institut de Cancérologie Gustave Roussy</wicri:noRegion></affiliation></author><author><name sortKey="Verhoef, Cornelis" sort="Verhoef, Cornelis" uniqKey="Verhoef C" first="Cornelis" last="Verhoef">Cornelis Verhoef</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Erasmus MC Cancer Institute</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Smithers, B Mark" sort="Smithers, B Mark" uniqKey="Smithers B" first="B. Mark" last="Smithers">B. Mark Smithers</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital</s1><s2>Woolloongabba, QLD</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Woolloongabba, QLD</wicri:noRegion></affiliation></author><author><name sortKey="Green, Adele C" sort="Green, Adele C" uniqKey="Green A" first="Adele C." last="Green">Adele C. Green</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group</s1><s2>Brisbane</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Brisbane</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Sciences Centre</s1><s2>Manchester</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region><settlement type="city">Manchester</settlement></placeName><orgName type="university">Université de Manchester</orgName></affiliation></author></analytic><series><title level="j" type="main">European journal of cancer : (1990)</title><title level="j" type="abbreviated">Eur. j. cancer : (1990)</title><idno type="ISSN">0959-8049</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">European journal of cancer : (1990)</title><title level="j" type="abbreviated">Eur. j. cancer : (1990)</title><idno type="ISSN">0959-8049</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cancerology</term><term>Clinical stage</term><term>Lymph</term><term>Lymphadenectomy</term><term>Malignant melanoma</term><term>Metastasis</term><term>Nomogram</term><term>Prediction</term><term>Predictive factor</term><term>Prognosis</term><term>Relapse</term><term>Survival</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Mélanome malin</term><term>Nomogramme</term><term>Facteur prédictif</term><term>Métastase</term><term>Prédiction</term><term>Récidive</term><term>Survie</term><term>Stade clinique</term><term>Traitement</term><term>Lymphadénectomie</term><term>Pronostic</term><term>Lymphe</term><term>Cancérologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Manchester</li><li>Hollande-Méridionale</li></region><settlement><li>Manchester</li><li>Rotterdam</li></settlement><orgName><li>Université de Manchester</li></orgName></list><tree><country name="Australie"><noRegion><name sortKey="Khosrotehrani, Kiarash" sort="Khosrotehrani, Kiarash" uniqKey="Khosrotehrani K" first="Kiarash" last="Khosrotehrani">Kiarash Khosrotehrani</name></noRegion><name sortKey="Allan, Christopher" sort="Allan, Christopher" uniqKey="Allan C" first="Christopher" last="Allan">Christopher Allan</name><name sortKey="Barbour, Andrew" sort="Barbour, Andrew" uniqKey="Barbour A" first="Andrew" last="Barbour">Andrew Barbour</name><name sortKey="Bayley, Gerard" sort="Bayley, Gerard" uniqKey="Bayley G" first="Gerard" last="Bayley">Gerard Bayley</name><name sortKey="Green, Adele C" sort="Green, Adele C" uniqKey="Green A" first="Adele C." last="Green">Adele C. Green</name><name sortKey="Hughes, Maria Celia" sort="Hughes, Maria Celia" uniqKey="Hughes M" first="Maria Celia" last="Hughes">Maria Celia Hughes</name><name sortKey="Khosrotehrani, Kiarash" sort="Khosrotehrani, Kiarash" uniqKey="Khosrotehrani K" first="Kiarash" last="Khosrotehrani">Kiarash Khosrotehrani</name><name sortKey="Siskind, Victor" sort="Siskind, Victor" uniqKey="Siskind V" first="Victor" last="Siskind">Victor Siskind</name><name sortKey="Smithers, B Mark" sort="Smithers, B Mark" uniqKey="Smithers B" first="B. Mark" last="Smithers">B. Mark Smithers</name><name sortKey="Thomas, Janine" sort="Thomas, Janine" uniqKey="Thomas J" first="Janine" last="Thomas">Janine Thomas</name><name sortKey="Wright, Annaliesa" sort="Wright, Annaliesa" uniqKey="Wright A" first="Annaliesa" last="Wright">Annaliesa Wright</name></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van Der Ploeg, Augustinus P T" sort="Van Der Ploeg, Augustinus P T" uniqKey="Van Der Ploeg A" first="Augustinus P. T." last="Van Der Ploeg">Augustinus P. T. Van Der Ploeg</name></region><name sortKey="Eggermont, Alexander" sort="Eggermont, Alexander" uniqKey="Eggermont A" first="Alexander" last="Eggermont">Alexander Eggermont</name><name sortKey="Verhoef, Cornelis" sort="Verhoef, Cornelis" uniqKey="Verhoef C" first="Cornelis" last="Verhoef">Cornelis Verhoef</name></country><country name="France"><noRegion><name sortKey="Eggermont, Alexander" sort="Eggermont, Alexander" uniqKey="Eggermont A" first="Alexander" last="Eggermont">Alexander Eggermont</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Green, Adele C" sort="Green, Adele C" uniqKey="Green A" first="Adele C." last="Green">Adele C. Green</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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