Experts Develop Nomograms to Predict T1 Melanoma Recurrence

Researchers have proposed using 3 externally validated nomograms to predict local, regional, and distant recurrence in patients with thin (T1, ≤1.0 mm) primary cutaneous melanomas (J Clin Oncol. 2021 Feb 18. Epub ahead of print).

The prognosis for most patients with T1 melanomas is generally excellent, the authors said, but some develop recurrence.

To develop the nomograms, the study analyzed data from a population-based cohort of 25,930 Dutch patients and a validation cohort of 2,968 patients from an Australian melanoma treatment center. The median follow-up was 6.7 years in the Dutch cohort and 12 years in the Australian cohort. Local, regional, and distant recurrences were found in 209 (0.8%) 503 (1.9%), and 203 (0.8%) patients in the Dutch cohort, and 23 (0.8%), 61 (2.1%), and 75 (2.5%) in the Australian cohort, respectively.

For the Dutch development model, C-statistics were 0.79 (95% CI, 0.75-0.82) for local recurrence-free survival (RFS), 0.77 (95% CI, 0.75-0.78) for regional RFS, and 0.80 (95% CI, 0.77-0.83) for distant RFS. For the validation cohort, C-statistics were 0.80 (95% CI, 0.69-0.90) for local RFS, 0.76 (95% CI, 0.70-0.82) for regional RFS, and 0.74 (95% CI, 0.69-0.80) for distant RFS.

Utilizing the nomograms, C-statistic increased by 9% to 12% in the development cohort and by 11% to 15% in the validation cohort, compared with the American Joint Committee on Cancer staging system using the T-stage and sentinel node status to predict T1 melanoma survival.

Researchers concluded that the nomograms that were developed in this study can accurately identify T1 melanoma patients at higher risk of either local, regional or distant recurrence.

An online tool to help guide the management of patients with T1 melanomas is available here.Emily Bader

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