Evidence map›Paper›PMID 41545611›Full record

ArticleAnnals of surgical oncology2026

Patterns and Predictors of Sentinel Lymph Node Biopsy Utilization in High- and Low-Risk Thin Melanomas.

Mackenzie M Mayhew, Emily G Tocco, Margaret G Mercante, Nidhi Kuchimanchi, Chengli Shen, Mohamad El Moheb, Samantha Ruff, Lynn T Dengel, Craig L Slingluff, Russell G Witt

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Mackenzie M Mayhew *Department of Surgery, University of Virginia, Charlottesville, VA, USA.
Emily G Tocco *Department of Surgery, University of Virginia, Charlottesville, VA, USA.
Margaret G Mercante *Department of Surgery, University of Virginia, Charlottesville, VA, USA.
Nidhi KuchimanchiDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Chengli ShenDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Mohamad El MohebDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Samantha RuffDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Lynn T DengelDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Craig L SlingluffDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Russell G WittDepartment of Surgery, University of Virginia, Charlottesville, VA, USA. syd3xz@uvahealth.org.ORCID http://orcid.org/0000-0003-3747-8633

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSentinel lymph node biopsy (SLNB) is recommended for patients with >10% risk of metastasis and not for those with <5% risk. The National Comprehensive Cancer Network acknowledges that individualized risk assessment tools, such as the Melanoma Institute of Australia (MIA) sentinel node metastasis risk model, may aid decision-making. We hypothesized that SLNB utilization would not differ substantially between the pre- and post-publication eras of the MIA model.

methodsWe retrospectively reviewed National Cancer Database data from 2018 to 2022. Patients with thin melanomas (<1.0 mm Breslow depth) were classified into <5% or >10% sentinel node positivity risk groups using the MIA model. Demographic and pathologic characteristics were examined.

resultsOf 58,119 patients with thin melanomas, 43,551 met inclusion criteria after excluding 14,491 with intermediate (5-10%) risk. Among 3949 with >10% risk, 62.9% had SLNB and 37.1% had SLNB omitted. Conversely, among 39,602 with <5% risk, 13.7% received SLNB. Tumor thickness, ulceration, and mitotic rate were significant predictors of SLNB in both groups. Increasing age was associated with lower odds of SLNB only in the low-risk cohort. Notably, SLNB utilization changed minimally following publication of the MIA model, increasing by <1% in the <5% group and 4% in the >10% group.

conclusionsBefore and after MIA model publication, SLNB was underutilized in high-risk patients and overutilized in low-risk patients. Utilization was primarily driven by tumor-specific factors. Our findings suggest limited early adoption of the model and highlight the need for improved dissemination of personalized risk stratification tools.

Indexed as

MelanomaSentinel Lymph NodeSentinel Lymph Node BiopsySkin NeoplasmsAdultAgedFemaleFollow-Up StudiesHumansLymphatic MetastasisMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentClinical guidelinesCutaneous melanomaLymph node metastasisRisk calculatorSentinel lymph node biopsy

Identifiers

PMID41545611
PMCPMC13083517

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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.