Strouse et al identified risk factors affecting survival in pediatric patients with malignant melanoma. These can help identify patients who may benefit from more aggressive management and closer monitoring. The authors are from the Johns Hopkins University and the National Cancer Institute at NIH.
Patient selection: malignant melanoma diagnosed prior to age 20
Outcome: death from malignant melanoma
Parameters:
(1) age of the patient
(2) gender of the patient
(3) location of the melanoma
(4) extent of disease
(5) history of previous cancer
(6) year of diagnosis (in the NCI database covering 1973 to 2001)
|
Parameter |
Finding |
Points |
|
age of the patient |
0 to 9 |
0 |
|
|
10 to 19 |
1 |
|
gender of the patient |
female |
0 |
|
|
male |
1 |
|
location of the melanoma |
torso or extremity |
0 |
|
|
head, neck, genitals, overlapping region, eye, CNS, mucosa, other |
1 |
|
extent of disease |
localized |
0 |
|
|
other (regional, distant, unstaged) |
1 |
|
history of previous cancer |
none |
0 |
|
|
present |
1 |
|
year of diagnosis |
later year of diagnosis |
0 |
|
|
earlier year of diagnosis |
1 |
where:
• In multivariate analysis the hazard ratio increased with age (Table 3, page 4740). The point assignment above is based on Figure 3, page 4738.
• The year of diagnosis was applicable to analyzing the database, but seems of little use in prospective analysis.
total number of risk factors =
= SUM(points for all of the parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 6 (the year of diagnosis is not used in the implementation, giving a maximum number of 5 risk factors)
• The greater the number of risk factors the worse the prognosis.
Specialty: Hematology Oncology, Surgery, general, Dermatology
