Population-based prognostic instrument (SweMR 2.0) for melanoma-specific survival - An ideal tool for individualised treatment decisions for Swedish patients
Lyth, Johan ; Mikiver, Rasmus ; Nielsen, Kari LU
; Ingvar, Christian
LU
; Olofsson Bagge, Roger
and Isaksson, Karolin
LU
(2023)
In European Journal of Surgical Oncology
49(10).
- Abstract
INTRODUCTION: The prognosis for patients with melanoma has improved due to better treatments in recent years and updated tools to accurately predict an individual's risk are warranted. This study aims to describe a prognostic instrument for patients with cutaneous melanoma and its potential as a clinical device for treatment decisions.
METHODS: Patients with localised invasive cutaneous melanoma diagnosed in 1990-2021 with data on tumour thickness were identified from the population-based Swedish Melanoma Registry. The parametric Royston-Parmar (RP) method was used to estimate melanoma-specific survival (MSS) probabilities. Separate models were constructed for patients (≤1 mm) and (>1 mm) and prognostic groups were created... (More)
INTRODUCTION: The prognosis for patients with melanoma has improved due to better treatments in recent years and updated tools to accurately predict an individual's risk are warranted. This study aims to describe a prognostic instrument for patients with cutaneous melanoma and its potential as a clinical device for treatment decisions.
METHODS: Patients with localised invasive cutaneous melanoma diagnosed in 1990-2021 with data on tumour thickness were identified from the population-based Swedish Melanoma Registry. The parametric Royston-Parmar (RP) method was used to estimate melanoma-specific survival (MSS) probabilities. Separate models were constructed for patients (≤1 mm) and (>1 mm) and prognostic groups were created based on all combinations of age, sex, tumour site, tumour thickness, absence/presence of ulceration, histopathologic type, Clark's level of invasion, mitoses and sentinel lymph node (SLN) status.
RESULTS: In total, 72 616 patients were identified, 41 764 with melanoma ≤1 mm and 30 852 with melanoma >1 mm. The most important variable was tumour thickness for both (≤1 mm) and (>1 mm), that explained more than 50% of the survival. The second most important variables were mitoses (≤1 mm) and SLN status (>1 mm). The prognostic instrument successfully created probabilities for >30 000 prognostic groups.
CONCLUSIONS: The Swedish updated population-based prognostic instrument, predicts MSS survival up to 10 years after diagnosis. The prognostic instrument gives more representative and up-to-date prognostic information for Swedish patients with primary melanoma than the present AJCC staging. Additional to clinical use and the adjuvant setting, the information retrieved could be used to plan future studies.
(Less)
- author
- Lyth, Johan
; Mikiver, Rasmus
; Nielsen, Kari
LU
; Ingvar, Christian
LU
; Olofsson Bagge, Roger
and Isaksson, Karolin
LU
- organization
- publishing date
- 2023-07-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Journal of Surgical Oncology
- volume
- 49
- issue
- 10
- article number
- 106974
- publisher
- Elsevier
- external identifiers
-
- scopus:85164673690
- pmid:37423872
- ISSN
- 1532-2157
- DOI
- 10.1016/j.ejso.2023.06.026
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
- id
- 039a668d-88dc-4a9b-9928-345e492cb195
- date added to LUP
- 2023-07-11 11:26:41
- date last changed
- 2024-04-19 23:18:46
@article{039a668d-88dc-4a9b-9928-345e492cb195,
abstract = {{<p>INTRODUCTION: The prognosis for patients with melanoma has improved due to better treatments in recent years and updated tools to accurately predict an individual's risk are warranted. This study aims to describe a prognostic instrument for patients with cutaneous melanoma and its potential as a clinical device for treatment decisions.</p><p>METHODS: Patients with localised invasive cutaneous melanoma diagnosed in 1990-2021 with data on tumour thickness were identified from the population-based Swedish Melanoma Registry. The parametric Royston-Parmar (RP) method was used to estimate melanoma-specific survival (MSS) probabilities. Separate models were constructed for patients (≤1 mm) and (>1 mm) and prognostic groups were created based on all combinations of age, sex, tumour site, tumour thickness, absence/presence of ulceration, histopathologic type, Clark's level of invasion, mitoses and sentinel lymph node (SLN) status.</p><p>RESULTS: In total, 72 616 patients were identified, 41 764 with melanoma ≤1 mm and 30 852 with melanoma >1 mm. The most important variable was tumour thickness for both (≤1 mm) and (>1 mm), that explained more than 50% of the survival. The second most important variables were mitoses (≤1 mm) and SLN status (>1 mm). The prognostic instrument successfully created probabilities for >30 000 prognostic groups.</p><p>CONCLUSIONS: The Swedish updated population-based prognostic instrument, predicts MSS survival up to 10 years after diagnosis. The prognostic instrument gives more representative and up-to-date prognostic information for Swedish patients with primary melanoma than the present AJCC staging. Additional to clinical use and the adjuvant setting, the information retrieved could be used to plan future studies.</p>}},
author = {{Lyth, Johan and Mikiver, Rasmus and Nielsen, Kari and Ingvar, Christian and Olofsson Bagge, Roger and Isaksson, Karolin}},
issn = {{1532-2157}},
language = {{eng}},
month = {{07}},
number = {{10}},
publisher = {{Elsevier}},
series = {{European Journal of Surgical Oncology}},
title = {{Population-based prognostic instrument (SweMR 2.0) for melanoma-specific survival - An ideal tool for individualised treatment decisions for Swedish patients}},
url = {{http://dx.doi.org/10.1016/j.ejso.2023.06.026}},
doi = {{10.1016/j.ejso.2023.06.026}},
volume = {{49}},
year = {{2023}},
}