{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:27:10Z","timestamp":1740104830339,"version":"3.37.3"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T00:00:00Z","timestamp":1694304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metastasis in a nonsentinel lymph node (non\u2010SLN) is an unfavorable independent prognostic factor in cutaneous melanoma (CM). Recent data did suggest potential value of completion lymph node dissection (CLND) in CM patients with non\u2010SLN metastasis. Prediction of non\u2010SLN metastasis assists clinicians in deciding on adjuvant therapy without CLND. We analyzed risk factors and developed a prediction model for non\u2010SLN status in acral melanoma (AM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study enrolled 656 cases of melanoma who underwent sentinel lymph node biopsy at Fudan University Shanghai Cancer Center from 2009 to 2017. We identified 81 SLN\u2009+\u2009AM patients who underwent CLND. Clinicopathologic data, including SLN tumor burden and non\u2010SLN status were examined with Cox and Logistics regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ulceration, Clark level, number of deposits in the SLN (NumDep) and maximum size of deposits (MaxSize) are independent risk factors associated with non\u2010SLN metastases. We developed a scoring system that combines ulceration, the cutoff values of Clark level V, MaxSize of 2\u2009mm, and NumDep of 5 to predict non\u2010SLN metastasis with an efficiency of 85.2% and 100% positive predictive value in the high\u2010rank group (scores of 17\u201324).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A scoring system that included ulceration, Clark level, MaxSize, and NumDep is reliable and effective for predicting non\u2010SLN metastasis in SLN\u2010positive AM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27438","type":"journal-article","created":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T08:24:26Z","timestamp":1694334266000},"page":"1407-1415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of nonsentinel lymph node metastasis in acral melanoma with positive sentinel lymph 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