Predictive value of a nomogram for melanomas with brain metastases at initial diagnosis

Abstract

Background Estimation of incidence and prognosis of melanomas with brain metastases (MBM) at initial diagnosis based on a large cohort is lacking in current research. This study aims to construct an effective prognostic nomogram for newly diagnosed MBM. Materials and Methods Patients diagnosed with melanomas from Surveillance, Epidemiology, and End Results program between 2010 and 2014 were enrolled in our study. Risk factors predicting brain metastases (BM) were identified using logistic regression analysis. Cox regression analysis was performed to identify prognostic factors of overall survival (OS). Nomogram for estimating 6‐, 9‐, and 12‐month OS was established based on Cox regression analysis. The discriminative ability and calibration of the nomogram were tested using C statistics, calibration plots, and Kaplan‐Meier curves. Results Sixty‐two thousand three hundred and sixty‐nine melanoma patients were enrolled, including 928 with BM. Sex, marital status, insurance status, subsite, surgery of primary sites, radiation, chemotherapy, bone metastases, liver metastases, and lung metastases were associated with MBM at initial diagnosis. On multivariable Cox regression, the following eight variables were incorporated in the prediction of OS: age, unmarried status, absence of surgery to primary sites or unknown, absence of radiation or unknown, absence of chemotherapy or unknown, with bone metastases, with liver metastases, and with lung metastases. The nomogram showed good predictive ability as indicated by discriminative ability and calibration, with the C statistics of 0.716 (95% CI, 0.695‐0.737). Conclusions The incidence and prognosis of MBM patients were well estimated in this study based on a large cohort. The nomogram performed well and could be a useful tool to predict prognosis.

Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study

“…These findings show that patients with HNM require close follow-up. Ulceration, lymph node stage and metastasis have been identified as significant independent factors of cutaneous melanoma in previous studies and were also identified in our study [26,28].…”

“…The Surveillance, Epidemiology, and End Results (SEER) database provides information on cancer incidence, treatment and survival from 18 population-based cancer registries, covering 28% of the US population [23]. Many studies have utilized the high-quality database to analyze melanoma characteristics, risks and prognoses [24][25][26]. Lachiewicz et al collected SEER data from 1992 to 2003 to examine survival differences between patients with scalp or neck melanoma and those with melanoma of other sites [27].…”

Comparing the Characteristics and Predicting the Survival of Head and Neck Melanoma versus Body Melanoma: A Population-based Study

“…Ulceration, lymph node stage and metastasis have been identi ed as signi cant independent factors of cutaneous melanoma in previous studies and were also identi ed in our study [26,27]. Notably, when presenting distant metastasis, compared to HNM patients, BM patients had worse 5-year CSS and OS rates.…”

“…Kevin et al [14] performed a comparison of 4561 pediatric patients with HNM or BM, but they did not study prognostic factors. Previous studies have identi ed signi cant independent prognostic factors of melanoma, and some nomograms were developed for predicting the OS or CSS of nonmetastatic melanoma patients, melanoma patients with brain metastases or nodular melanoma patients [6,[24][25][26][27]. To date, a speci c nomogram for HNM or BM has not been developed.…”

Development and validation of prognostic nomogram in patients with nonmetastatic malignant melanoma: a SEER population‐based study

“…16,17 To date, nomogram is widely used to help physician accurately and timely estimate the prognosis of patients. 15,17 Previous several studies have reported that primary clinical features were correlated with prognosis of patients with CMMs, 15,18,19 but few studies constructed a nomogram, based on those common clinical features, to predict the survival rate of patients with NMMM. 19 Therefore, our purpose of the present study was to identify clinicopathological factors associated with prognosis basing on the data from SEER database.…”