Are Nomograms Useful for Predicting Sentinel Lymph Node Status in Melanoma Patients?

BACKGROUND AND OBJECTIVES

Clinical nomograms have been developed to predict sentinel lymph node (SLN) status in early-stage melanoma patients, but the clinical utility of these tools remains debatable. We created and validated a nomogram using data from a randomized clinical trial and assessed its accuracy against the well-validated Melanoma Institute Australia (MIA) nomogram.

METHODS

We developed our model to predict SLN status using logistic regression on clinicopathological patient data from the Multicenter Selective Lymphadenectomy Trial-I. The model was externally validated using the National Cancer Database (NCDB) data set, and its performance was compared to that of the MIA nomogram.

RESULTS

Our model had good discrimination between positive and negative SLNs, with a training set area under the curve (AUC) of 0.706 (0.661-0.751). Our model achieved an AUC of 0.715 (0.706-0.724) compared to 0.723 (0.715-0.731) with the MIA model, using the NCDB set.

CONCLUSION

Our model performed similarly to the MIA model, confirming that despite using different clinical features and data sets, no clinical nomogram is currently accurate enough for clinical use.