Evidence map›Paper›PMID 37574516›Full record

ArticleAnnals of surgical oncology2023

Prognostic Significance of Sentinel Lymph Node Status in Thick Primary Melanomas (> 4 mm).

Carl-Jacob Holmberg, Rasmus Mikiver, Karolin Isaksson, Christian Ingvar, Marc Moncrieff, Kari Nielsen, Lars Ny, Johan Lyth, Roger Olofsson Bagge

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 10% 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

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Giant thick melanomas: a retrospective case series.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Article
  3. Article
  4. Article
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

9 authors at 4 institutions in 2 countries.

Carl-Jacob HolmbergDepartment of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Rasmus MikiverDepartment of Clinical and Experimental Medicine, Regional Cancer Center Southeast Sweden, Linköping University, Linköping, Sweden.
Karolin IsakssonDepartment of Surgery, Kristianstad Hospital, Kristianstad, Sweden.
Christian IngvarDivision of Surgery, Department of Clinical Sciences, Lund University, Lund, Sweden.
Marc MoncrieffDepartment of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
Kari NielsenLund University Cancer Centre, Lund University, Lund, Sweden.
Lars NyDepartment of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Johan LythDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Roger Olofsson BaggeDepartment of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. roger.olofsson.bagge@gu.se.ORCID http://orcid.org/0000-0001-5795-0355
Lund University · SESahlgrenska University Hospital · SELinköping University · SENorfolk and Norwich University Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe key prognostic factors for staging patients with primary cutaneous melanoma are Breslow thickness, ulceration, and sentinel lymph node (SLN) status. The multicenter selective lymphadenectomy trial (MSLT-I) verified SLN status as the most important prognostic factor for patients with intermediate-thickness melanoma (Breslow thickness, 1-4 mm). Although most international guidelines recommend SLN biopsy (SLNB) also for patients with thick (> 4 mm, pT4) melanomas, its prognostic role has been questioned. The primary aim of this study was to establish whether SLN status is prognostic in T4 melanoma tumors.

methodsData for all patients with a diagnosis of primary invasive cutaneous melanoma of Breslow thickness greater than 1 mm in Sweden between 2007 and 2020 were retrieved from the Swedish Melanoma Registry, a large prospective population-based registry. A multivariable Cox proportional hazard model for melanoma-specific survival (MSS) was constructed based on Breslow thickness stratified for SLN status.

resultsThe study enrolled 10,491 patients, 1943 of whom had a Breslow thickness greater than 4 mm (pT4). A positive SLN was found for 34% of these pT4 patients. The 5-year MSS was 71%, and the 10-year MSS was 62%. There was a statistically significant difference in MSS between the patients with a positive SLN and those with a negative SLN (hazard ratio of 2.4 (95% confidence interval CI 1.6-3.5) for stage T4a and 2.0 (95% CI 1.6-2.5) for satage T4b.

conclusionSentinel lymph node status gives important prognostic information also for patients with thick (> 4 mm) melanomas, and the authors thus recommend that clinical guidelines be updated to reflect this.

Indexed as

LymphadenopathyMelanomaSentinel Lymph NodeSkin NeoplasmsCutaneous Malignant MelanomaHumansLymph NodesPrognosisProspective StudiesSentinel Lymph Node Biopsy

Identifiers

PMID37574516
PMCPMC10625939
OpenAlexW4385791071

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.