Melanoma Institute of Australia's Sentinel Node Metastasis Risk Prediction Tool validated

July 18, 2023

Abstract

Background: To improve patient selection for sentinel node biopsy, the Melanoma Institute of Australia (MIA) created a predictive model based on readily available clinicopathologic factors.

Objective: Validation of the MIA nomogram using the National Cancer Database (NCDB), a nationwide oncology outcomes database for more than 1,500 Commission-accredited cancer programs in the United States.

Methods: A total of 60,165 patients were included in the validation. The probability of sentinel node (SN) positivity was calculated for each patient. Using calculated probabilities, a receiver operating characteristic (ROC) curve was generated to assess the model’s discrimination ability.

Results: At baseline, the NCDB cohort had different clinicopathologic characteristics compared to the original MIA dataset. Despite these differences, the MIA nomogram retained high predictive accuracy within the NCDB dataset (C-statistic: 0.733 [95% CI: 0.726 to 0.739]), though calibration weakened for the highest-risk decile.

Limitations: The NCDB collects data from hospital registries accredited by the Commission on Cancer (CoC).

Conclusion: In conclusion, this study validated the use of the MIA nomogram in a nationwide oncology outcomes database collected from more than 1,500 Commission-accredited cancer programs in the United States, demonstrating the potential for this nomogram to predict SN positivity and reduce the number of negative SN biopsies.

Reference:

S. Caleb Freeman, Elena Paz Munoz, Emile Latour, Jeong Youn Lim, Wesley Yu,
External validation of the Melanoma Institute Australia Sentinel Node Metastasis Risk Prediction Tool using the National Cancer Database,
Journal of the American Academy of Dermatology, 2023, ISSN 0190-9622,
https://doi.org/10.1016/j.jaad.2023.07.011.