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01-01-2008 | Melanomas

N-Ratio: a Novel Independent Prognostic Factor for Patients with Stage-III Cutaneous Melanoma

Authors: Carlo Riccardo Rossi, MD, Simone Mocellin, MD, PhD, Sandro Pasquali, MD, Pierluigi Pilati, MD, Donato Nitti, MD

Published in: Annals of Surgical Oncology | Issue 1/2008

Abstract

Background

In this study, we tested the hypothesis that the ratio between metastatic and excised lymph nodes (“N-ratio”) might have an independent prognostic value in patients with TNM stage-III cutaneous melanoma.

Methods

The clinical records of 213 melanoma patients who had undergone radical lymph node dissection (RLND) and were found to harbor pathology-proven metastatic disease were used for analysis. The following clinico-pathological variables were considered for the prognostic study: patient’s age and sex, primary tumor site, tumor thickness, Clark’s level, ulceration, absolute number of positive lymph nodes, total number of excised lymph nodes, TNM stage (IIIA, IIIB, IIIC), and N-ratio (N-ratio A, ≤10%; N-ratio B, 10–25%; N-ratio C, >25%).

Results

Patients were categorized into three N-ratio classes according to the percentage of metastatic lymph nodes (N-ratio A, n = 94; N-ratio B, n = 95; N-ratio C, n = 24). The mean follow-up was 40 months. At univariate survival analysis, tumor thickness (P < 0.0001), ulceration (P = 0.046), Clark’s level (P = 0.0002), number of positive lymph nodes (P < 0.0001), TNM stage (P < 0.0001), and N-ratio (P < 0.0001) were significantly associated with overall survival (OS). Interestingly, the Cox proportional hazard model showed that, along with tumor thickness (HR 1.069, P = 0.008) and TNM stage (HR 1.696, P = 0.015), N-ratio (HR 1.578, P = 0.012) also independently predicted OS.

Conclusions

N-ratio is a novel easy-to-obtain independent prognostic factor for melanoma patients with lymph node metastases and might provide clinicians with additional information suitable for patient stratification while choosing adjuvant treatment. Validation of these results in larger prospective series is warranted to implement N-ratio in the routine clinical setting.

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Title: N-Ratio: a Novel Independent Prognostic Factor for Patients with Stage-III Cutaneous Melanoma
Authors: Carlo Riccardo Rossi, MD
Simone Mocellin, MD, PhD
Sandro Pasquali, MD
Pierluigi Pilati, MD
Donato Nitti, MD
Publication date: 01-01-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 1/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9641-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

N-Ratio: a Novel Independent Prognostic Factor for Patients with Stage-III Cutaneous Melanoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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