Publication date: Jul 07, 2025
Sentinel lymph node biopsy (SLNB) is crucial for staging and managing melanoma, but selecting patients for SLNB is challenging, with around 80% of procedures yielding negative results. The clinicopathological and gene expression profile model (CP-GEP) was developed to identify low-risk melanoma patients who may forgo SLNB. CP-GEP combines Breslow thickness, patient age, and a gene expression analysis to classify patients as high- or low-risk for nodal metastasis. This study aimed to validate the performance of CP-GEP in a multicenter Danish cohort. Primary melanoma tissue from 536 T1-T3 patients who had undergone SLNB was retrospectively analyzed using CP-GEP. Results were compared with SLNB status and the Melanoma Institute Australia nomogram (MIA). T1, T2, and T3 melanomas comprised 32. 8%, 46. 8%, and 20. 3% of cases, respectively. The SLNB positivity rate was 18. 1%. Overall, 40. 9% was classified as CP-GEP low-risk (NPV 91. 3%). Among T1 and T2 subgroups, 72. 7% and 35. 5% were low-risk, with NPVs of 94. 5% and 87. 6%, respectively. For 507 patients with MIA scores, CP-GEP identified 42. 4% as low-risk (NPV 91. 2%) versus 8. 1% by MIA (NPV 95. 1%). CP-GEP is a promising tool for supporting deselection of SLNB in melanoma patients, with a potential reduction rate of over 40%.
| Concepts | Keywords |
|---|---|
| Australia | Cancer biomarker |
| Clinicopathologic | CP‐GEP |
| Danish | gene expression profiling |
| Sentinel | melanoma |
| risk stratification |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Metastasis |
| disease | MESH | Melanoma |
| pathway | KEGG | Melanoma |