Evidence map›Paper›PMID 31667924›Full record

ArticleANZ journal of surgery2020

Current management of patients with melanoma who are found to be sentinel node-positive.

Amanda A G Nijhuis, Andrew J Spillane, Jonathan R Stretch, Robyn P M Saw, Alexander M Menzies, Roger F Uren, John F Thompson, Omgo E Nieweg

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ANZ journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 2 countries.

Amanda A G NijhuisMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0169-5444
Andrew J SpillaneMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Jonathan R StretchMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Robyn P M SawMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Alexander M MenziesMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Roger F UrenFaculty of Medicine and Health, The University of Sydney School of Medicine, Sydney, New South Wales, Australia.
John F ThompsonMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-2816-2496
Omgo E NiewegMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
The University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe results of the DeCOG-SLT and MSLT-II studies, published in 2016 and mid-2017, indicated no survival benefit from completion lymph node dissection (CLND) in melanoma patients with positive sentinel nodes (SNs). Subsequently, several studies have been published reporting a benefit of adjuvant systemic therapy in patients with stage III melanoma. The current study assessed how these findings influenced management of SN-positive patients in a dedicated melanoma treatment centre.

methodsSN-positive patients treated at Melanoma Institute Australia between July 2017 and December 2018 were prospectively identified. Surgeons completed a questionnaire documenting the management of each patient. Information on patients, primary tumours, SNs, further treatment and follow-up was collected from patient files, the institutional research database and pathology reports.

resultsDuring the 18-month study period, 483 patients underwent SN biopsy. A positive SN was found in 61 (13%). Two patients (3%) requested CLND because of anxiety about observation in view of unfavourable primary tumour and SN characteristics. The other 59 patients (97%) were followed with a four-monthly ultrasound examination of the relevant lymph node field(s). Two of them (3%) developed an isolated nodal recurrence after 4 and 11 months of follow-up. Fifty-seven patients (93%) were seen following the publication of the first two adjuvant systemic therapy studies in November 2017; 46 (81%) were referred to a medical oncologist to discuss adjuvant systemic therapy, which 32 (70%) chose to receive.

conclusionAt Melanoma Institute Australia most patients with an involved SN are now managed without CLND. The majority are referred to a medical oncologist and receive adjuvant systemic therapy.

Indexed as

MelanomaSentinel Lymph NodeSkin NeoplasmsAustraliaHumansLymph Node ExcisionSentinel Lymph Node Biopsyimmunotherapylymph node dissectionMelanomamolecular targeted therapysentinel lymph node biopsy

Identifiers

PMID31667924
PMCPMC7216885
OpenAlexW2984811873

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.