title: Risk assessment in localized primary cutaneous melanoma: a Southwest Oncology Group study evaluating nine factors and a test of the Clark logistic regression prediction model.
abstract: We studied 9 clinical and pathologic factors in 259 patients using Cox model regression analysis to determine which factors have independent predictive value. Median follow-up time in all patients still alive was 12.3 years (range, 1.7 to 16.7 years). Tumor-infiltrating lymphocytes (P = .005), primary site (P = .006), and thickness (P = .02) had independent predictive value. Ulceration (P = .06) and age (P = .07) had marginal value. We used 6 of those factors to test the Clark logistic regression prediction model, which accurately predicted 8-year survival in 121 (72.9%) of 166 patients and accurately predicted melanoma-specific mortality in 32 (43%) of 74 patients. The combined or overall accuracy of the Clark model was only 64%.
authors.affiliation: Department of Anatomic Pathology, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Tuthill
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Unger
authors.forename: P Y
authors.initials: PY
authors.lastname: Liu
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Flaherty
authors.forename: Vernon K
authors.initials: VK
authors.lastname: Sondak
mesh_terms: D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D016019:Survival Analysis; D015996:Survival Rate