Individualized Prognosis and Recurrence Risk Scores of Cochran et al for Patients with Malignant Melanoma

Description

Cochran et al developed risk scores that can be used to give individualized prognostic estimates for patients with malignant melanoma. The study was done at the UCLA School of Medicine and the John Wayne Cancer Institute in California.

Parameters for Survival Risk Score	Parameters for Disease Free Survival
gender
age
Breslow thickness	Breslow thickness
ulceration	ulceration
site	site
	melanoma subsite

Parameters for Survival Risk Score	Finding	Points
gender	male	1.8
	female	1
age	< 60 years	1
	>= 60 years	3.3
Breslow thickness in mm	0 – < 1 mm	1
	1 – < 2 mm	2
	2 – < 6 mm	3.8
	>= 6 mm	7.5
ulceration in mm	0	1
	> 0 and < 2 mm	1.6
	2 - < 5 mm	2.6
	>= 5 mm	4.2
site	head	1.5
	trunk	1.5
	extremity	1

where:

• The table shows overlap in the ranges for Breslow thickness and ulceration. I added ">" and "<" as seemed appropriate.

survival risk score =

= PRODUCT(points for all 5 parameters)

Parameter for Disease Free Survival Subscore	Finding	Points
site	head	2.1
	trunk	2.1
	extremity	1
Breslow thickness in mm	0 – < 1 mm	1
	1 – < 2 mm	1.8
	2 – < 6 mm	3.4
	>= 6 mm	6.2
ulceration in mm	0	1
	> 0 and < 2 mm	1.4
	2 - < 5 mm	2.0
	>= 5 mm	2.9
melanoma subtype	nodular	1.7
	acral lentiginous	1.7
	lentigo maligna melanoma	1.4
	superficial spreading	1.0
	unclassifiable	1.2

where:

• The table shows overlap in the ranges for Breslow thickness and ulceration. I added ">" and "<" as seemed appropriate.

recurrence risk score =

= PRODUCT(points for all 4 parameters)

Interpretation:

• minimum risk score for survival or recurrence: 1

• maximum risk score for survival: 280.67

• maximum risk score for recurrence: 64.19

probability of survival at X years =

= (normal survival rate at X years) ^ (survival risk score)

Number of Years (X)	Normal Survival Rate
3	0.987
5	0.975
10	0.960

probability of disease free survival at Y years =

= (normal disease free survival rate at Y years) ^ (recurrence risk score)

probability of recurrence =

= 1 – (probability of disease free survival)

Number of Years (Y)	Normal Disease Free Survival Rate
1	0.995
3	0.979
5	0.971
10	0.957

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Individualized Prognosis and Recurrence Risk Scores of Cochran et al for Patients with Malignant Melanoma

Description

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