ArticleBritish journal of cancer2026
Implications of wait times for sentinel node biopsy on melanoma disease progression, micrometastatic tumour burden and survival outcomes in the modern treatment era.
Article in British journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSentinel node biopsy (SNB) predicts long-term melanoma outcomes and advises referrals for adjuvant systemic therapy (AST). Concerns regarding the impact of treatment delays on clinical outcomes remain.
methodsA UK retrospective cohort study at a supra-regional centre was performed, including 1625 patients listed for SNB between 2010-23. Three parameters were investigated: disease progression, micrometastatic burden, and disease-specific survival. Time-to-SNB was stratified as early (≤90days) or late (>90days), with a subgroup analysis accounting for AST use (2017-23). Sensitivity analyses calculated a wait-time threshold beyond which worsens survival outcomes.
resultsMedian time-to-SNB was 68 days (IQR = 51-95) and follow-up 75 months (IQR = 35-115). Late surgery correlated with disease progression before surgery (0.34% versus 1.54%; OR = 4.31; p = 0.022); larger micrometastases (1.40 mm vs. 2.95 mm; p = 0.003), and increased high-risk micrometastatic deposits >1 mm (55.2% vs. 69.1%; OR = 2.04; p = 0.014). For patients post-2016, longer wait-times correlated with poorer DSS (HR = 1.01 (1.00-1.02); p = 0.011 for diagnosis-to-SNB; and HR = 1.01 (1.00-1.02); p = 0.016 for primary excision-to-SNB). Sensitivity analyses calculated ≤68-days from diagnosis (HR = 3.17 (1.19-8.46); p = 0.021) and ≤82-days from excision (HR = 2.94 (1.10-7.87); p = 0.032) as optimal treatment thresholds.
conclusionSurgical delays correlated with harm: disease progression, increased tumour burden and worse survival. SNB should occur within 68 days from diagnosis and/or 82 days from excision biopsy.
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