A prognostic nomogram for the cancer-specific survival of white patients with invasive melanoma at BANS sites based on the Surveillance, Epidemiology, and End Results database

Jia-Nan Huang; Hai Yu; Yang Wan; Wai-Kit Ming; Fangmin Situ; Leqing Zhu; Yuzhen Jiang; U Tim Wu; WenHsien Ethan Huang; Wenhui Chen; Jun Lyu; Liehua Deng

doi:10.3389/fmed.2023.1167742

A prognostic nomogram for the cancer-specific survival of white patients with invasive melanoma at BANS sites based on the Surveillance, Epidemiology, and End Results database

Front Med (Lausanne). 2023 Jul 11:10:1167742. doi: 10.3389/fmed.2023.1167742. eCollection 2023.

Authors

Jia-Nan Huang¹, Hai Yu¹, Yang Wan², Wai-Kit Ming³, Fangmin Situ¹, Leqing Zhu⁴, Yuzhen Jiang⁵, U Tim Wu⁶, WenHsien Ethan Huang⁷, Wenhui Chen⁸, Jun Lyu^{9

10}, Liehua Deng^{1

11}

Affiliations

¹ Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China.
² Guangzhou Jnumeso Bio-technology Co., Ltd., Guangzhou, China.
³ Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China.
⁴ Guangzhou Laboratory, Bioland, Guangzhou, China.
⁵ Royal Free Hospital and University College London, London, United Kingdom.
⁶ Meng Yi Centre Limited, Macau, Macau SAR, China.
⁷ GeneHope Clinic, Taipei, China.
⁸ Shanghai Aige Medical Beauty Clinic Co., Ltd. (Agge), Shanghai, China.
⁹ Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.
¹⁰ Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China.
¹¹ Department of Dermatology, The Fifth Affiliated Hospital of Jinan University, Heyuan, China.

Abstract

Objective: The purpose of this study was to develop a comprehensive nomogram for the cancer-specific survival (CSS) of white patients with invasive melanoma at back, posterior arm, posterior neck, and posterior scalp (BANS) sites and to determine the validity of the nomogram by comparing it with the conventional American Joint Committee on Cancer (AJCC) staging system.

Methods: This study analyzed the patients with invasive melanoma in the Surveillance, Epidemiology, and End Results (SEER) database. R software was used to randomly divide the patients into training and validation cohorts at a ratio of 7:3. Multivariable Cox regression was used to identify predictive variables. The new survival nomogram was compared with the AJCC prognosis model using the concordance index (C-index), area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), calibration plotting, and decision-curve analysis (DCA).

Results: A novel nomogram was established to determine the 3-, 5-, and 8-year CSS probabilities of patients with invasive melanoma. According to the nomogram, the Age at Diagnosis had the greatest influence on CSS in invasive melanoma, followed by Bone Metastasis, AJCC, Stage, Liver Metastasis, Histologic Subtype, Brain Metastasis, Ulceration, and Primary Site. The nomogram had a higher C-index than the AJCC staging system in both the training (0.850 versus 0.799) and validation (0.829 versus 0.783) cohorts. Calibration plotting demonstrated that the model had good calibration ability. The nomogram outperformed the AJCC staging system in terms of AUC, NRI, IDI, and DCA.

Conclusion: This was the first study to develop and evaluate a comprehensive nomogram for the CSS of white patients with invasive melanoma at BANS sites using the SEER database. The novel nomogram can assist clinical staff in predicting the 3-, 5-, and 8-year CSS probabilities of patients with invasive melanoma more accurately than can the AJCC staging system.

Keywords: BANS sites; Epidemiology; Surveillance; and End Results database; cancer-specific survival; invasive melanoma; nomogram.