预测哪些美国癌症联合委员会 (AJCC) T1-T2 黑色素瘤患者的前哨淋巴结 (SLN) 呈阳性具有挑战性。澳大利亚黑色素瘤研究所 (MIA) 开发了一款经过国际验证的 SLN 转移风险计算器。本研究评估了列线图对 MIA 的 T1-T2 黑色素瘤患者管理的影响。比较了 2018 年 7 月 1 日至 2019 年 6 月 30 日和 2020 年 8 月 1 日至 2021 年 7 月 31 日列线图前后期间的 SLN 活检 (SLNB) 率，总共确定了 850 名患者（列线图前，383 名；列线图后，467 名）。列线图前组中有 29.0% 的患者进行了前哨淋巴结活检，列线图后组中有 34.5% 的患者进行了前哨淋巴结活检 (p = 0.091)。列线图前组的总体阳性率为 16.2%，列线图后组的总体阳性率为 14.9% (p = 0.223)。列线图前组 (1.1%, n = 2/177) 的 T1a 黑色素瘤患者中进行 SLNB 的频率低于列线图后组 (8.6%, n = 17/198) [p ≤ 0.001]。这种增加尤其适用于风险评分≥5% 的黑色素瘤，列线图后组的 SLN 阳性率为 11.8% (p = 0.004)，而相比之下为零。对于风险评分 > 10% 的 T1b 黑色素瘤，列线图前 SLNB 率为 40.0% (8/20)，列线图后 SLNB 率为 75.0% (12/16) (p = 0.049)。在这个专业中心，SLN风险计算器似乎影响了以前被认为转移风险较低的黑色素瘤的实践，随着 T1a 和高风险 T1b 黑色素瘤使用 SLNB 的增加。需要在更广泛的实践环境中进行进一步评估。黑色素瘤管理指南可以更新，以纳入列线图的可用性，以便比以前的标准更好地选择进行 SLNB 的患者。© 2024。作者。

Predicting which patients with American Joint Committee on Cancer (AJCC) T1-T2 melanomas will have a positive sentinel lymph node (SLN) is challenging. Melanoma Institute Australia (MIA) developed an internationally validated SLN metastatic risk calculator. This study evaluated the nomogram's impact on T1-T2 melanoma patient management at MIA.SLN biopsy (SLNB) rates were compared for the pre- and post-nomogram periods of 1 July 2018-30 June 2019 and 1 August 2020-31 July 2021, respectively.Overall, 850 patients were identified (pre-nomogram, 383; post-nomogram, 467). SLNB was performed in 29.0% of patients in the pre-nomogram group and 34.5% in the post-nomogram group (p = 0.091). The overall positivity rate was 16.2% in the pre-nomogram group and 14.9% in the post-nomogram group (p = 0.223). SLNB was performed less frequently in T1a melanoma patients in the pre-nomogram group (1.1%, n = 2/177) than in the post-nomogram group (8.6%, n = 17/198) [p ≤ 0.001]. This increase was particularly for melanomas with a risk score ≥ 5%, with an SLN positivity rate of 11.8% in the post-nomogram group (p = 0.004) compared with zero. For T1b melanomas with a risk score of > 10%, the SLNB rate was 40.0% (8/20) pre-nomogram and 75.0% (12/16) post-nomogram (p = 0.049).In this specialized center, the SLN risk calculator appears to influence practice for melanomas previously considered low risk for metastasis, with increased use of SLNB for T1a and higher-risk T1b melanomas. Further evaluation is required across broader practice settings. Melanoma management guidelines could be updated to incorporate the availability of nomograms to better select patients for SLNB than previous criteria.© 2024. The Author(s).