Wong et al reported a nomogram for predicting metastis to a sentinel lymph node from a malignant melanoma. This can help to guide management. The authors are from Memorial Sloan-Kettering Cancer Center, Cleveland Clinic and the University of Louisville.
Patient selection: malignant melanoma
Parameters:
(1) age in years from 20 to 100 years
(2) site of the tumor
(3) Breslow thickness in mm from 0 to 10 mm
(4) Clark level II to V
(5) ulceration
Parameter
Finding
Points
site
head and neck
0
extremity
18.5
trunk
22.3
Clark level
II or III
0
IV
28.8
V
19.9
ulceration
no
0
yes
19.9
Age in Years
Points
20 to 60 years
39.385 - (0.223 * (age))
60 to 100
65.712 - (0.656 * (age))
Thickness in mm
Points
0 to 4
(-4.9617 * ((mm)^2)) + (43.582 * (mm)) - 4.7388
4 to 10
(1.65 * (mm)) + 83.5
score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 205.9
• The higher the score the greater the chances of metastasis to a sentinel lymph node.
Score
< 32.9
< 1%
>= 32.9
value of X = (0.026599 * (score)) - 5.4597
probability = 1/(1+EXP((-1)*X))
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