Web-based nomograms for predicting the prognosis of adolescent and young adult skin melanoma, a large population-based real-world analysis

BACKGROUND: Invasive cutaneous melanoma is one of the most common malignant diseases among adolescents and young adults (aged 15–40 years) in the United States. We aimed to develop web-based nomograms to precisely predict overall survival and cancer-specific survival in this group of patients with cutaneous melanoma. METHODS: We analyzed the overall and caner-specific death events in 19,887 patients who underwent surgical resection of cutaneous melanoma from Surveillance, Epidemiology and End Results database and developed web-based clinic-pathologic prediction models for overall survival and cancer specific survival based on Cox regression. C-statistics of Harrell and time-dependent Receiver Operating Characteristic Curve (ROC) were used to evaluate the prognostic accuracy of nomograms. RESULTS: Multivariate Cox regression model analysis suggested that age, sex, race, tumor location, Clark level, ulceration, thickness, and N stage were independently associated with both overall survival and cancer-specific survival in adolescent and young adult patients with cutaneous melanoma. The nomograms performed excellently in predicting overall survival and cancer-specific survival with C-index being 0.875 (95% CI: 0.847–0.903) and 0.901 (95% CI: 0.876–0.925), respectively. Time-dependent ROC verified that the prognostic accuracy of nomograms was better than that of American Joint Committee on Cancer staging system and other prognostic factors. CONCLUSIONS: These user-friendly nomograms can precisely predict overall survival and cancer-specific survival in cutaneous melanoma patients treated with surgical resection, which may help to make individualized postoperative follow-up and therapeutic schemes.