Creating and Providing Predictions of Melanoma Outcome

Tanabe, Kenneth K.; Jara, Sebastian M.; Michaelson, James

doi:10.1245/s10434-010-1054-8

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Using melanoma survival calculators, one can see that the risk for melanoma recurrence becomes minimal after five to six years, especially with other favorable prognostic features. 4,13,14 The lifemath.net melanoma outcome calculator can be used to illustrate the impact of conditional survival for an individual melanoma patient (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

Conditional Survival-Based “Abbreviated” Routine Cancer Surveillance for Pathologic Stage IB Melanoma

Kukar

Gabriel

May

et al. 2017

The American Surgeon™

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A negative sentinel lymph node biopsy (SLNB) for stage IB (T1b/T2a N0) melanoma would predict an excellent long-term prognosis. Combined with the concept of conditional survival, an “abbreviated” cancer surveillance strategy was implemented to reduce the number of visits and total length of follow-up. Retrospective review of all pathologic stage IB melanoma patients (negative SLNB) at a single institution between 2006 and 2008 after implementation of an “abbreviated” cancer surveillance; clinic visits every six months for five years followed by one annual visit (total follow-up six years). Patient demographics, tumor characteristics, and information regarding recurrences were obtained. Recurrence-free, disease-specific, and overall survival were calculated. Eighty-seven patients underwent the “abbreviated” cancer surveillance. Median age was 55.4 years and 50.6 per cent were male. Median Breslow thickness was 1.1 mm (range 0.5–2.0 mm) and 1.1 per cent were ulcerated. Primary tumor site was 49 per cent extremities, 39 per cent trunk, and 12 per cent head/ neck. Median follow-up was 68.6 months. Five-year recurrence-free, disease-specific, and overall survivals were 89, 95, and 88 per cent, respectively. During surveillance, 10 patients had concerning symptoms or physical findings prompting subsequent workup, all of which were negative for recurrence/metastases. There were only three true melanoma recurrences; all were distant metastases and presented symptomatically between scheduled follow-up visits. In light of the excellent prognosis for pathologic (SLNB negative) stage IB melanoma, an “abbreviated” cancer surveillance schedule based on conditional survival would reduce both direct and indirect costs in this cohort. The few recurrences were symptomatic and unlikely to have changed with more intensive surveillance.

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Section: Discussionmentioning

confidence: 99%

Conditional Survival-Based “Abbreviated” Routine Cancer Surveillance for Pathologic Stage IB Melanoma

Kukar

Gabriel

May

et al. 2017

The American Surgeon™

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“…To improve the accuracy of predicting sentinel lymph node positivity, investigators from various institutions have developed online prognostic calculators based on large databases of patients with melanoma (Table 2). [44][45][46][47] The four available nomograms vary in terms of what patient and tumor factors emerged as predictive based on their development pool. Common features of all nomograms include patient age, Breslow thickness, and ulceration status.…”

Section: Snb In Thin Melanoma: Using Nomograms Wiselymentioning

confidence: 99%

Current Controversies in Melanoma Treatment

Temple‐Oberle¹,

Nicholas²,

Rojas-García³

2023

Plastic &Amp; Reconstructive Surgery

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Learning Objectives: After reading this article and viewing the videos, the participant should be able to: 1. Discuss margins for in situ and invasive disease and describe reconstructive options for wide excision defects, including the keystone flap. 2. Describe a digit-sparing alternative for subungual melanoma. 3. Calculate personalized risk estimates for sentinel node biopsy using predictive nomograms. 4. Describe the indications for lymphadenectomy and describe a technique intended to reduce the risk of lymphedema following lymphadenectomy. 5. Offer options for in-transit melanoma management. Summary: Melanoma management continues to evolve, and plastic surgeons need to stay at the forefront of advances and controversies. Appropriate margins for in situ and invasive disease require consideration of the trials on which they are based. A workhorse reconstruction option for wide excision defects, particularly in extremities, is the keystone flap. There are alternative surgical approaches to subungual tumors besides amputation. It is now possible to personalize a risk estimate for sentinel node positivity beyond what is available for groups of patients with a given stage of disease. Sentinel node biopsy can be made more accurate and less morbid with novel adjuncts. Positive sentinel node biopsies are now rarely managed with completion lymphadenectomy. Should a patient require lymphadenectomy, immediate lymphatic reconstruction may mitigate the lymphedema risk. Finally, there are minimally invasive modalities for effective control of in-transit recurrences.

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Adjuvant Therapy in the Treatment of Melanoma

Bello

Ariyan

2018

Ann Surg Oncol

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Creating and Providing Predictions of Melanoma Outcome

Cited by 3 publications

References 7 publications

Conditional Survival-Based “Abbreviated” Routine Cancer Surveillance for Pathologic Stage IB Melanoma

Conditional Survival-Based “Abbreviated” Routine Cancer Surveillance for Pathologic Stage IB Melanoma

Current Controversies in Melanoma Treatment

Adjuvant Therapy in the Treatment of Melanoma

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