Predicting Survival Outcome of Localized Melanoma: An Electronic Prediction Tool Based on the AJCC Melanoma Database
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
We sought to develop a reliable and reproducible statistical model to predict the survival outcome of patients with localized melanoma.
A total of 25,734 patients with localized melanoma from the 2008 American Joint Committee on Cancer (AJCC) Melanoma Database were used for the model development and validation. The predictive model was developed from the model development data set (n = 14,760) contributed by nine major institutions and study groups and was validated on an independent model validation data set (n = 10,974) consisting of patients from a separate melanoma center. Multivariate analyses based on the Cox model were performed for the model development, and the concordance correlation coefficients were calculated to assess the adequacy of the predictive model.
Patient characteristics in both data sets were virtually identical, and tumor thickness was the single most important prognostic factor. Other key prognostic factors identified by stratified analyses included ulceration, lesion site, and patient age. Direct comparisons of the predicted 5- and 10-year survival rates calculated from the predictive model and the observed Kaplan-Meier 5- and 10-year survival rates estimated from the validation data set yielded high concordance correlation coefficients of 0.90 and 0.93, respectively. A Web-based electronic prediction tool was also developed (http://www.melanomaprognosis.org/).
This is the first predictive model for localized melanoma that was developed based on a very large data set and was successfully validated on an independent data set. The high concordance correlation coefficients demonstrated the accuracy of the predicted model. This predictive model provides a clinically useful tool for making treatment decisions, for assessing patient risk, and for planning and analyzing clinical trials.
- Balch CM, Murad, TM, Soong SJ, Ingalls AL, Halpern NB, Maddox WA. A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark’s and Breslow’s staging methods. Ann Surg. 1978;88:732–42. CrossRef
- Eldh J, Boeryd B, Peterson LE. Prognostic factors in cutaneous malignant melanoma in stage I. A clinical, morphological and multivariate analysis. Scand J Plast Reconstr Surg. 1978;12:243–55. CrossRef
- Balch CM, Soong SJ, Murad TM, Ingalls AL, Maddox WA. A multifactorial analysis of melanoma. II. Prognostic factors in patients with stage I (localized) melanoma. Surgery. 1980;86:343–51.
- Balch CM, Soong SJ, Murad TM, Ingalls AL, Maddox WA. A multifactorial analysis of melanoma. III. Prognostic factors in melanoma patients with lymph node metastases (stage II). Ann Surg. 1981;193:377–88. CrossRef
- Van Der Esch EP, Cascinelli N, Preda F, Morabito A., Bufalina R. Stage I melanoma of the skin: evaluation of prognosis according to histologic characteristics. Cancer. 1981;48:1668–73. CrossRef
- Drzewiecki, KT, Andersen PK. Survival with malignant melanoma: a regression analysis of prognostic factors. Cancer. 1982;49:2414–9. CrossRef
- Balch CM, Soong SJ, Milton GW, et al. A comparison of prognostic factors and surgical results in 1,786 patients with localized (stage I) melanoma treated in Alabama, USA, and New South Wales, Australia. Ann Surg. 1982;196:677–84. CrossRef
- Balch CM, Soong SJ, Murad TM, Smith JW, Maddox WA, Durant JR. A multifactorial analysis of melanoma. IV. Prognostic factors in 200 melanoma patients with distant metastases (stage III). J Clin Oncol. 1983;1:126–34.
- Coit DG, Rogatko A., Brennan MF. Prognostic factors in patients with melanoma metastatic to axillary or inguinal lymph nodes. A multivariate analysis. Ann Surg. 1991;214:627–36. CrossRef
- Morton DL, Davtyan DG, Wanek LA, et al. Multivariate analysis of the relationship between survival and the microstage of primary melanoma by Clark level and Breslow thickness. Cancer. 1993;71:3737.
- Buttner P, Garbe C, Bertz J, et al. Primary cutaneous melanoma Optimized cutoff points of tumor thickness and importance of Clark’s level for prognostic classification. Cancer. 1995;75:2499. CrossRef
- Balch CM, Soong SJ, Gershenwald JE, et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol. 2001;19:3622–34.
- Gershenwald JE, Balch CM, Soong SJ, Thompson JF. Prognostic factors and natural history. In: Balch CM, Houghton AN, Sober AJ, Soong SJ, Atkins MB, Thompson JF, editors. Cutaneous melanoma. 5th ed. St Louis, MO: Quality Medical Publishing; 2009. p. 35–64.
- Balch CM, Milton GW, Shaw HM, Soong SJ, eitors. Cutaneous melanoma: clinical management and treatment results worldwide. Philadelphia: Lippincott; 1985.
- Soong SJ. A computerized mathematical model and scoring system for predicting outcome in melanoma patients. In: Balch CM, Milton GW, editors. Cutaneous melanoma: clinical management and treatment results worldwide. Philadelphia: Lippincott; 1985. p. 353.
- Clark WH Jr, Elder DE, Guerry D, et al. Model predicting survival in stage I melanoma based upon tumor progression. J Natl Cancer Inst. 1989;81:1893–904. CrossRef
- MacKie RM, Aitchison T, Sirel JM, McLaren K, Watt DC. Prognostic models for subgroups of melanoma patients from the Scottish Melanoma Group database 1979–86, and their subsequent validation. Br J Cancer. 1995;71:173–6.
- Barnhill RL, Fine JA, Roush GC, Berwick M. Predicting five-year outcome for patients with cutaneous melanoma in a population-based study. Cancer. 1996;78:427–32. CrossRef
- Schuchter L, Schultz DJ, Synnestvedt M, Trock BJ, Guerry D, Elder DE, Elenitsas R, et al. A prognostic model for predicting 10-years survival in patients with primary melanoma. The Pigmented Lesion Group. Ann Intern Med. 1996;125:369–75.
- Sahin S, Rao B, Kopf AW, Lee E, Rigel DS, Nossa R, Rahman IJ, et al. Predicting ten-year survival of patients with primary cutaneous melanoma: a corroboration of a prognostic model. Cancer. 1997;80:1426–31. CrossRef
- Soong SJ, Zhang Y, Desmond R. Models for predicting outcome. In: Balch CM, Houghton AN, Sober A, Soong SJ, editors. Cutaneous melanoma. 4th ed. St. Louis: Quality Medical Publishing; 2003. p. 77–90.
- Soong SJ, Shaw HM, Balch CM, McCarthy WH, Urist MM, Lee JY. Predicting survival and recurrence in localized melanoma: a multivariate approach. World J Surg. 1992;16:191–5. CrossRef
- Balch CM, Buzaid AC, Soong SJ, Atkins MB, Cascinelli N, Coit DG, Fleming ID, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol. 2001;19:3635–48.
- Ding S, Soong SJ, Lin HY, Desmond R, Balch CM. Parametric modeling of localized melanoma prognosis and outcome. J Biopharm Stat. 2009;19:732–47. CrossRef
- Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, Buzaid AC, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27(36):6199–206. CrossRef
- Cox DR. Regression models and life tables. J R Statist Soc. 1972;B34:187.
- Predicting Survival Outcome of Localized Melanoma: An Electronic Prediction Tool Based on the AJCC Melanoma Database
Annals of Surgical Oncology
Volume 17, Issue 8 , pp 2006-2014
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Author Affiliations
- 1. Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
- 2. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA
- 3. Departments of Surgery, Oncology and Dermatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
- 4. Departments of Surgical Oncology and Cancer Biology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
- 5. Sydney Melanoma Unit, Royal Prince Alfred Hospital, Camperdown, Australia
- 6. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA