Individualized Prediction for Risk of Recurrence in Stage I/II Melanoma Patients With Negative Sentinel Lymph Node.

Background: Despite the favorable prognosis of AJCC stage I/II melanoma patients, up to 20%-30% will develop metastases. Our objective is to predict long-term risk (probability) of recurrence in early-stage melanoma patients.

Methods: A Risk Score to predict long-term recurrence was developed using Cox regression based on 2668 patients.

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.

Implications of tumor-positive sentinel lymph nodes in single vs multiple nodal basins in melanoma.

Background: Melanoma patients' prognosis is based on the primary tumor characteristics and the tumor status of the regional lymph nodes. The advent of lymphoscintigraphy with SLN biopsy (SLNB) has shown that melanoma can drain to multiple nodal basins but the significance of multiple basins (vs. one basin) with tumor-positive sentinel lymph node(s) (+SLN) of similar tumor burden has not been shown.

Socially vulnerable patients are more likely to fail outpatient management of symptomatic cholelithiasis.

Background: Symptomatic cholelithiasis is a common surgical problem, with many patients requiring multiple gallstone-related emergency department (ED) visits before cholecystectomy. The Social Vulnerability Index (SVI) identifies vulnerable patient populations. This study aimed to assess the association between social vulnerability and outpatient management of symptomatic cholelithiasis.

Is therapeutic lymph node dissection of value for lymph node recurrence in melanoma?

Background: Therapeutic lymphadenectomy (TLND) is still performed in most melanoma patients to treat nodal recurrences after initial negative lymph node biopsy (-SLNB), despite the lack of evidence for survival benefit. We sought to compare melanoma-specific survival (MSS) and distant metastasis-free survival (DMFS) of patients who underwent TLND versus no TLND using our institutional and MSTL-1 databases.

Methods: We identified 146 patients with nodal recurrence following -SLNB: 132 underwent TLND and 14 did not.