ArticleJournal of the American College of Surgeons2021
Surveillance of Sentinel Node-Positive Melanoma Patients with Reasons for Exclusion from MSLT-II: Multi-Institutional Propensity Score Matched Analysis.
Article in Journal of the American College of Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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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.
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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.
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Who cites it
9 citing papers in PubMed, 23 citations in OpenAlex.
- Prognostic significance of isolated clinically detected regional melanoma metastasis in minor nodal basins.World journal of surgical oncology · 2026Article
- National Evaluation of the Management of Melanoma Patients with Multiple Positive Sentinel Lymph Nodes.Annals of surgical oncology · 2026Article
- Impact of Social Determinants of Health on Melanoma Nodal Surveillance in a Multi-institutional Cohort.Annals of surgical oncology · 2025Article
- Long-term outcomes of nodal surveillance practices in sentinel node positive melanoma: An early post MSLT-II cohort.American journal of surgery · 2025Article
- Management of melanoma: can we use gene expression profiling to help guide treatment and surveillance?Clinical & experimental metastasis · 2024Review
- International Center-Level Variation in Utilization of Completion Lymph Node Dissection and Adjuvant Systemic Therapy for Sentinel Lymph Node-Positive Melanoma at Major Referral Centers.Annals of surgery · 2023Article
- The Evolution of the Sentinel Node Biopsy in Melanoma.Life (Basel, Switzerland) · 2023Review
- Surgical Management of Melanoma: Advances and Updates.Current oncology reports · 2022Review
- Evidence and implementation gaps in management of sentinel node-positive melanoma in the United States.Surgery · 2022Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
48 authors at 20 institutions in 6 countries.
Funding
Abstract
backgroundIn sentinel lymph node (SLN)-positive melanoma, two randomized trials demonstrated equivalent melanoma-specific survival with nodal surveillance vs completion lymph node dissection (CLND). Patients with microsatellites, extranodal extension (ENE) in the SLN, or >3 positive SLNs constitute a high-risk group largely excluded from the randomized trials, for whom appropriate management remains unknown. STUDY
designSLN-positive patients with any of the three high-risk features were identified from an international cohort. CLND patients were matched 1:1 with surveillance patients using propensity scores. Risk of any-site recurrence, SLN-basin-only recurrence, and melanoma-specific mortality were compared.
resultsAmong 1,154 SLN-positive patients, 166 had ENE, microsatellites, and/or >3 positive SLN. At 18.5 months median follow-up, 49% had recurrence (vs 26% in patients without high-risk features, p < 0.01). Among high-risk patients, 52 (31%) underwent CLND and 114 (69%) received surveillance. Fifty-one CLND patients were matched to 51 surveillance patients. The matched cohort was balanced on tumor, nodal, and adjuvant treatment factors. There were no significant differences in any-site recurrence (CLND 49%, surveillance 45%, p = 0.99), SLN-basin-only recurrence (CLND 6%, surveillance 14%, p = 0.20), or melanoma-specific mortality (CLND 14%, surveillance 12%, p = 0.86).
conclusionsSLN-positive patients with microsatellites, ENE, or >3 positive SLN constitute a high-risk group with a 2-fold greater recurrence risk. For those managed with nodal surveillance, SLN-basin recurrences were more frequent, but all-site recurrence and melanoma-specific mortality were comparable to patients treated with CLND. Most recurrences were outside the SLN-basin, supporting use of nodal surveillance for SLN-positive patients with microsatellites, ENE, and/or >3 positive SLN.
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