• Eduardo Bertolli, Mariana Petaccia de Macedo, Vinícius Fernando Calsavara, Clovis Antonio Lopes Pinto, and João Pedreira Duprat Neto.
• Skin Cancer Department, AC Camargo Cancer Center, São Paulo, Brazil. Electronic address: ebertolli@hotmail.com.
• J. Am. Acad. Dermatol. 2019 Mar 1; 80 (3): 722-726.

BackgroundMelanoma patients with negative nodes after sentinel lymph node biopsy are a heterogeneous group. Current guidelines fail to adequately stratify surveillance and treatment for this group. Also, there is scarce data on adjuvant treatments for these patients.ObjectiveTo create a nomogram including clinical and pathologic characteristics capable of evaluating the risk for recurrence of primary melanoma patients with negative sentinel lymph node biopsies (SLNBs).MethodsWe used a retrospective cohort of patients who underwent SLNB during 2000-2015 at a single institution.ResultsOur cohort comprised 1213 patients. Among these patients, 967 (79.7%) had a negative SLNB, and mean follow-up was 59.67 months. There were 133 recurrences (13.8%); 45 (33.8%) presented with nodal recurrence, and 35 (26.3%) recurred where a SLNB was performed. Breslow thickness, ulceration, and microsatellitosis were found to be predictive of risk for recurrence at 1, 2, 5, and 10 years.LimitationSingle center analysis.ConclusionWe created a predictive nomogram for melanoma patients with negative SLNBs. This nomogram is easy to use and identifies high-risk patients who should have more strict surveillance and be considered for adjuvant treatment.Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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