MSK Melanoma Nomogram: Predicts the probability of sentinel lymph node (SLN) metastasis in patients with cutaneous melanoma.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
To predict the probability of sentinel lymph node (SLN) metastasis in clinically node-negative cutaneous melanoma.
Aids in shared decision-making regarding whether to perform a Sentinel Lymph Node Biopsy (SLNBx).
Section 2
Formula & Logic
Algorithm Variables
Age at diagnosis (older age inversely correlates with SLN positivity but directly correlates with poorer survival).
Tumor Location (Extremity vs. Trunk vs. Head/Neck).
Breslow Thickness (mm).
Ulceration (Present/Absent).
Mitotic Rate (often integrated into older/updated models of the nomogram).
Section 3
Pearls/Pitfalls
Clinical Pearls
Highly valuable for "borderline" cases (e.g., T1b or thin T2a melanomas) to provide a localized, patient-specific percentage risk rather than generic population guidelines.
A threshold of 5-10% predicted risk is typically used to discuss/offer SLNBx.
Section 4
Next Steps
Surgical Planning
If predicted risk is high (typically >5%), referral for SLNBx along with wide local excision is standard of care.
