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N-SNORE Scoring System of Murali et al for Predicting Risk of Non-Sentinel Lymph Node Positivity for a Patient with Cutaneous Malignant Melanoma

Purpose: To predict the rate of metastases to non-sentinel lymph nodes in a patient with cutaneous melanoma and a positive sentinel lymph node.

Description

Murali et al developed the N-SNORE (non-sentinel node risk score) to predict the risk of metastases in non-sentinel lymph nodes for a patient with cutaneous melanoma and a positive sentinel lymph node. The authors are from the Royal Prince Albert Hospital, Melanoma Institute Australia, and University of Sydney in Australia.


Parameters:

(1) gender

(2) regression in the primary cutaneous lesion

(3) percent of sentinel lymph nodes containing melanoma

(4) perinodal lymphatic invasion in the sentinel lymph node

(5) maximum dimension of the largest tumor deposit in a sentinel lymph node

 

Parameter

Finding

Points

gender

female

0

 

male

1

regression in primary tumor

no

0

 

yes

2

percent of sentinel lymph nodes positive for melanoma

< 50%

0

 

>= 50%

2

perinodal lymphatic invasion

no

0

 

yes

3

maximum dimension of the largest metastasis

<= 0.5 mm

0

 

0.51 to 2 mm

1

 

2.01 to 10 mm

2

 

> 10 mm

3

 

total N-SNORE =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 11

• The higher the score the greater the risk of non-sentinel lymph node metastases.

 

N-SNORE

Percent Positive

0

0%

1 to 3

5 to 10%

4 or 5

15 to 20%

6 or 7

40 to 50%

8 to 11

70-80%

 


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Specialty

Objective

ICD-10