Evidence map›Paper›PMID 30307046›Full record

ArticleThe British journal of surgery2019

Development and validation of a nomogram to predict recurrence and melanoma-specific mortality in patients with negative sentinel lymph nodes.

D Verver, D van Klaveren, V Franke, A C J van Akkooi, P Rutkowski, U Keilholz, A M M Eggermont, T Nijsten, D J Grünhagen, C Verhoef

Abstract readMulticenter StudyValidation Study
In one paragraph

Article in The British journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  9. Predicting Recurrence-Free and Overall Survival for Patients With Stage II Melanoma: The MIA Calculator.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024
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  20. False-negative sentinel lymph node biopsy for melanoma: a single-surgeon experience.Canadian journal of surgery. Journal canadien de chirurgie
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

D VerverDepartment of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands.ORCID 0000-0003-0034-3575
D van KlaverenMedical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands.
V FrankeDepartment of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
A C J van AkkooiDepartment of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
P RutkowskiDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute Cancer Centre, Warsaw, Poland.
U KeilholzCharité Comprehensive Cancer Centre, University of Medicine Berlin, Berlin, Germany.
A M M EggermontDepartment of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
T NijstenDepartment of Dermatology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
D J GrünhagenDepartment of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands.
C VerhoefDepartment of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with melanoma and negative sentinel nodes (SNs) have varying outcomes, dependent on several prognostic factors. Considering all these factors in a prediction model might aid in identifying patients who could benefit from a personalized treatment strategy. The objective was to construct and validate a nomogram for recurrence and melanoma-specific mortality (MSM) in patients with melanoma and negative SNs.

methodsA total of 3220 patients with negative SNs were identified from a cohort of 4124 patients from four EORTC Melanoma Group centres who underwent sentinel lymph node biopsy. Prognostic factors for recurrence and MSM were studied with Cox regression analysis. Significant factors were incorporated in the models. Performance was assessed by discrimination (c-index) and calibration in cross-validation across the four centres. A nomogram was developed for graphical presentation.

resultsThere were 3180 eligible patients. The final prediction model for recurrence and the calibrated model for MSM included three independent prognostic factors: ulceration, anatomical location and Breslow thickness. The c-index was 0·74 for recurrence and 0·76 for the calibrated MSM model. Cross-validation across the four centres showed reasonable model performance. A nomogram was developed based on these models. One-third of the patients had a 5-year recurrence probability of 8·2 per cent or less, and one-third had a recurrence probability of 23·0 per cent or more.

conclusionA nomogram for predicting recurrence and MSM in patients with melanoma and negative SNs was constructed and validated. It could provide personalized estimates useful for tailoring surveillance strategies (reduce or increase intensity), and selection of patients for adjuvant therapy or clinical trials.

Indexed as

AgedFemaleHumansLymphatic MetastasisMaleMelanomaMiddle AgedNeoplasm Recurrence, LocalNomogramsPrognosisRetrospective StudiesSentinel Lymph NodeSkin Neoplasms

Identifiers

PMID30307046
PMCPMC6585628

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.