Maurichi et al developed a nomogram to predict survival for a patient with a thin malignant melanoma. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Italy, England and Greece.
Patient selection: thin melanoma (Breslow thickness <= 1 mm), age 15 to 80 years
Parameters:
(1) age in years
(2) mitotic rate per square mm
(3) ulceration
(4) lymphovascular invasion
(5) regression
(6) sentinel lymph node (SLN) status
|
Age in Years |
Parameter |
|
15 to 70 |
(-0.02635 * ((age)^2)) + (4.013 * (age)) - 55.39 |
|
70 to 80 |
(0.6 * (age)) + 52 |
|
Parameter |
Finding |
Points |
|
mitotic rate |
< 1 per square mm |
0 |
|
|
>= 1 per square mm |
9.1 |
|
ulceration |
absent |
0 |
|
|
present |
26.7 |
|
lymphovascular invasion |
absent |
0 |
|
|
present |
11.9 |
|
regression |
absent |
0 |
|
|
present |
24.1 |
|
sentinel lymph node |
negative |
0 |
|
|
positive |
22.2 |
total score with sentinel lymph node =
= SUM(points for all 6 parameters)
total score without sentinel lymph node =
= SUM(points for the first 5 parameters)
Interpretation:
• minimum score: 0
• maximum score with sentinel lymh node: 193
• maximum score without sentinel lymph node: 171
• The higher the score the worse the 12-year overall survival.
|
Score without SLN |
12 Year Overall Survival |
|
< 79 |
> 95% |
|
79 to 125 |
(-0.01372 * ((points)^2)) + (2.052 * (points)) + 18.33 |
|
125 to 169 |
(0.0183 * ((points)^2)) - (6.709 * (points)) + 618.6 |
|
> 169 |
< 1% |
|
Score with SLN |
12 Year Overall Survival |
|
< 93 |
> 95% |
|
93 to 151 |
(-0.01519 * ((points)^2)) + (2.767 * (points)) - 31.33 |
|
151 to 183 |
(0.0304 * ((points)^2)) - (11.38 * (points)) + 1065 |
|
> 183 |
< 1% |
Specialty: Hematology Oncology, Surgery, general, Dermatology
