Web-based nomograms for predicting the prognosis of adolescent and young adult skin melanoma, a large population-based real-world analysis.

BACKGROUND

Invasive cutaneous melanoma is one of the most common malignant diseases among adolescents and young adults (aged 15-40 years) in the United States. We aimed to develop web-based nomograms to precisely predict overall survival and cancer-specific survival in this group of patients with cutaneous melanoma.

METHODS

We analyzed the overall and caner-specific death events in 19,887 patients who underwent surgical resection of cutaneous melanoma from Surveillance, Epidemiology and End Results database and developed web-based clinic-pathologic prediction models for overall survival and cancer specific survival based on Cox regression. C-statistics of Harrell and time-dependent Receiver Operating Characteristic Curve (ROC) were used to evaluate the prognostic accuracy of nomograms.

RESULTS

Multivariate Cox regression model analysis suggested that age, sex, race, tumor location, Clark level, ulceration, thickness, and N stage were independently associated with both overall survival and cancer-specific survival in adolescent and young adult patients with cutaneous melanoma. The nomograms performed excellently in predicting overall survival and cancer-specific survival with C-index being 0.875 (95% CI: 0.847-0.903) and 0.901 (95% CI: 0.876-0.925), respectively. Time-dependent ROC verified that the prognostic accuracy of nomograms was better than that of American Joint Committee on Cancer staging system and other prognostic factors.

CONCLUSIONS

These user-friendly nomograms can precisely predict overall survival and cancer-specific survival in cutaneous melanoma patients treated with surgical resection, which may help to make individualized postoperative follow-up and therapeutic schemes.