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CART Model of Kruper et al for Predicting Sentinel Lymph Node Metastases in a Patient with AJCC Stage I or II Malignant Melanoma

Description

Kruper et al performed a classification and regression tree (CART) analysis of patients with AJCC Stage I or II malignant melanoma to identify those at increased risk for metastases to sentinel lymph nodes (SLN). The authors are from the University of Pennsylvania in Philadelphia.


 

Patient selection: AJCC stage I or II

 

Parameters:

(1) tumor thickness in mm

(2) mitotic activity

(3) tumor infiltrating lymphocytes (TIL) with disruption of melanoma cell clusters

 

Thickness

Mitotic Activity

TIL

Percent with SLN Metastases

<= 2 mm

none

 

2% (0 - 5%)

<= 2 mm

any

Y

7% (4 - 10%)

<= 2 mm

any

N

18% (10 - 27%)

> 2 mm

 

Y

21% (14 - 27%)

> 2 mm

 

N

40% (27 - 54%)

 

where:

• Mitotic rate was reported in mitoses per square millimeter. This requires knowledge of the visual field area for the microscope lens used for the count. The number of high power fields to count = (1.0 square mm) / (area in square mm).

 


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